If untreated, Lyme disease can progress to chronic Lyme disease or stage 3 of Lyme disease. Stage 3 Lyme disease occurs months to years after the initial infection or during a period of latency. Most patients presenting with the late disease do not have erythema migrans because the rash urges the patient to seek treatment earlier.
Stage 3 Lyme disease symptoms include skin manifestation (acrodermatitis chronica atrophicans), Lyme arthritis, and nervous system abnormalities.
What is Lyme disease?

Lyme disease is a multisystem illness caused by infection with the microorganism, Borrelia burgdorferi, and the body’s immune response to its infection. The illness is transmitted from tick bites when the tick regurgitates the microorganism.
Thus, Lyme disease is known as a “vector-borne disease.” Because the ticks are extremely small and their bites are painless, the biting event very often goes unnoticed.
How long does it take to show signs of Lyme disease?
The signs and symptoms of Lyme disease usually appear one to 30 days after a tick bite, but most commonly between seven and 14 days. The first sign is usually a skin rash and flu-like symptoms.
What are the signs and symptoms of Lyme disease by stages?
There are three stages of Lyme disease, which are outlined below.
Stage 1 Early Localized Disease
- Occurs one to 30 days after a tick bite
- Erythema migrans
- characteristic skin rash of Lyme disease
- migrating red rash with a “bullseye” appearance occurring at or near the site of the tick bite
- asymptomatic or itches or burns
- develops around seven days after the tick bite
- rash expands over a matter of days
- an untreated rash may persist for two to three weeks
- Approximately half of the early disease patients have flu-like symptoms, which may resolve spontaneously
- low-grade fever
- chills
- muscle and joint pain
- headache
- neck stiffness
- swollen lymph nodes
Stage 2 Early Disseminated Disease
- Usually develops three to 10 weeks after the initial infection.
- One or more organ systems become involved through blood or lymphatic spread
- General symptoms:
- fever and uneasiness (malaise)
- dizziness
- unconsciousness
- difficulty breathing
- chest pain
- palpitations
- Eye manifestations:
- blurred or double vision
- eye pain
- blindness
- Heart manifestations:
- Nervous system manifestations:
- may occur two to 10 weeks after infection
- encephalopathy (a broad term for any brain disease that alters brain function or structure)
- meningitis (inflammation of the brain)
- headache
- neck pain or stiffness
- photophobia (sensitivity to light)
- nerve paralysis like facial nerve palsy (Bell palsy)
- disturbances in memory, concentration, mood, sleep, personality, and/or language
- depression
- irritability
- Skin manifestations:
- multiple erythema migrans lesions are present
- borrelial lymphocytoma (uncommon): bluish-red swelling that occurs on the lobe of the ear, scrotum, nose, and extremities.
Stage 3 Late Disease
Stage 3 Lyme disease occurs months to years after the initial infection or during a period of latency. Most patients presenting with the late disease do not have erythema migrans because the rash urges the patient to seek treatment earlier.
Symptoms of Stage 3 Lyme Disease may include the following:
- Skin manifestation:
- Acrodermatitis Chronica atrophicans: found almost exclusively in patients of European descent. It commonly affects older women with bluish-red discoloration on the back of the hands, feet, knees, and elbows.
- Lyme arthritis:
- typically involves one or a few large joints (the knee is involved in 90% of cases).
- severe inflammation and joint pain
- Nervous system abnormalities:
- encephalopathy
- encephalomyelitis (inflammation of the brain)
- neuropathy nerve paralysis
- acute spinal disk disease.
- hemiparesis (weakness of one side of the body)
- ataxia (loss of muscle coordination)
- seizures
- bladder dysfunction (loss of urinary control)
- hearing loss
- myelitis (inflammation of the spinal cord)
- paraparesis (paralysis of lower limbs)
- quadriparesis (paralysis of all limbs)

QUESTION
The term arthritis refers to stiffness in the joints. See AnswerWhat is the treatment of Lyme disease?
Lyme disease is commonly treated in the following ways:
- Treatment with oral and/or intravenous antibiotics to combat infection and medications to provide symptom relief.
- Removal of attached ticks.
How can I prevent Lyme disease?
Tips to prevent Lyme disease include:
- Personal and environmental measures to avoid ticks, mice, and other insects
- Removal of attached ticks from self, children, and pets
- Professional management of tick infestation at home
What is the prognosis of Lyme disease?
Prognosis is excellent and most patients recover completely, especially if treated early with appropriate antibiotics. Sometimes a recurrent infection can occur with certain strains, but Lyme disease can be managed well with medication. Co-infection by other organisms transmitted by the same tick bite can occur.
Top What Are the Stages of Lyme Disease Related Articles
Arthritis (Joint Inflammation)
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of arthritis, including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and gout.Can Lyme Disease Be Cured?
Lyme disease is a multisystem illness caused by infection with the microorganism, Borrelia burgdorferi, and the body’s immune response to its infection. The signs and symptoms of Lyme disease usually appear one to 30 days after a tick bite, but most commonly between seven to 14 days. Lyme disease is known as a vector-borne disease.Can Lyme Disease Be Detected by a Blood Test?
Lyme disease can be detected by tests that look for antibodies in the blood. Learn more about Lyme disease testing, stages, and symptoms.Is Lyme Disease Contagious?
Lyme disease may be transmitted to humans via the bite of an infected tick. The bacterium Borrelia burgdorferi causes the disease and is passed to humans during a tick's blood meal. Lyme disease does not spread from person to person.Lyme Disease
Lyme disease (borreliosis) is transmitted by the bite of a tick infected with Borrelia burgdorferi. After a bite, an expanding bulls-eye rash develops. Get the facts on chronic Lyme disease tests, symptoms, treatment, diagnosis, stages, and prevention. Plus, see pictures of the Lyme disease rash.Lyme Disease Pictures
Lyme disease is transmitted through a bite from a specific type of tick. See a picture of Lyme Disease and learn more about the health topic.Lyme Disease Slideshow
What is Lyme disease? Learn about symptoms and testing for Lyme disease, whether it is curable, and signs of Lyme disease caused by tick bites. See pictures of Lyme disease rashes and ticks that carry Lyme disease.Lyme Disease Quiz
What you do not know about Lyme disease may surprise you. Learn the causes, symptoms, treatments, and complications of this arthritic condition with the Lyme Disease Quiz.Lymepak (doxycycline hyclate)
Lymepak is a prescription medicine used for the treatment of early Lyme disease due to a bacteria known as Borrelia burgdorferi in adults and children 8 years of age and older weighing 99 pounds (lbs) (45 kg) and above. Serious side effects of Lymepak include harm to an unborn baby, harm to infants and children under 8 years of age, diarrhea, severe skin reactions, Jarisch-Herxheimer reaction, and increased pressure around the brain.What Are the Symptoms of Lyme Disease in Humans?
Lyme disease is an infection that is transmitted by ticks and is the most common vector-borne disease in the US. It is caused by infection with the spiral-shaped bacteria Borrelia burgdorferi or Borrelia mayonii (rarely) that resides in the stomach of the ticks. The infected ticks of the genus Ixodes, commonly called black-legged deer ticks, transmit this disease to humans via tick bites.What Are the Three Stages of Lyme Disease?
Lyme disease is an infectious disease transmitted to humans via ticks. People spending time outdoors are at the highest risk of contracting this disease, especially in woody, bushy and grassy areas of the northeastern and mid-northern US. The three stages of Lyme disease can overlap with each other, and patients may not go through all of the stages. Antibiotics are used to treat Lyme disease, and patients recover faster if treated in the early stages.What Does Lyme Disease Do to a Person?
Depending on the stage of infection, Lyme disease may affect a person in the following ways.What Will Make a Tick Back Out?
The easiest and simplest way to make a tick back out is to detach it manually with tweezers. Grasp the tick firmly with tweezers and pull it out. Visit your doctor right away if you are not able to separate the tick from your body.