What Are the Symptoms of Lyme Disease in Humans?

The signs and symptoms of Lyme disease depend upon the three stages of the infection, which are localized, disseminated, and persistent.

Lyme disease is an infection that is transmitted by ticks and is the most common vector-borne disease in the United States. 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 by regurgitating their stomach contents into skin.    

People who spend time outdoors, particularly in wooded, brushy, or grassy habitats, in areas where the disease is common, have a higher chance of tick bite and getting Lyme disease.

Tick bites are frequently never felt. Only 25-30% of United States patients with early stages of the disease can recall the tick bite. The signs and symptoms of Lyme disease depend upon the three stages of the infection, which are:

• Localized
• Disseminated
• Persistent

The first two stages are part of the early infection, whereas persistent disease is considered a late infection.

Symptoms in stage-1 Lyme disease

This stage occurs one to 30 days after the tick bite and comprises of the following symptoms:

• Rash: The typical Lyme disease rash is called erythema migrans.
  • It occurs at an average of seven days after the tick bite, at or near the site of the bite.
  • It appears reddish with a slightly clearer center forming a concentric ring of redness giving it a ‘bull’s eye’ appearance.
  • The rash is warm to touch and may or may not be associated with itching or burning sensation.
• Fever
• Chills
• Fatigue
• Body ache
• Joint pain
• Headache
• Neck stiffness
• Altered bowel movements

Symptoms of stage-2 Lyme disease

This stage is called the early disseminated Lyme disease and it usually develops three to 10 weeks after the tick bite. It is called ‘disseminated’ as the infection in this stage has spread from the skin to different sites in the body. The symptoms include:

• Fever
• Uneasiness or malaise
• Fatigue
• Pain in joints and muscles
• Dizziness
• Fainting episodes
• Difficulty in breathing
• Chest pain
• Palpitations
• Blurred vision
• Eye pain
• Loss of vision
• Weakness or paralysis of facial muscles
• Multiple rashes

Symptoms of stage-3 Lyme disease

Persistent Lyme disease occurs months to years after the initial infection. It can appear after an apparent symptom-free period. Prominent signs and symptoms at this stage are:

• ‘Cigarette paper’ appearance of the skin (Acrodermatitis chronica atrophicans) 
  • This is a characteristic skin manifestation of this stage.
  • It occurs on the hands, feet, knees, and elbows and gives a “cigarette paper” appearance to the skin.
• Joint pain and deformities
• Nerve pain
• Weakness or paralysis
• Difficulty in walking
• Seizures
• Bladder disturbances
• Hearing loss

Lyme disease is preventable, treatable, and curable. Appropriate treatment with antibiotics in the early stage of the disease gives the best results. The most used oral antibiotics for this disease are:

• Doxycycline
• Amoxicillin
• Cefuroxime axetil

Injectable antibiotics are used in people with brain and heart involvement and include:

• Ceftriaxone
• Penicillin

Patients with Lyme disease generally have an excellent recovery when they are treated early with appropriate antibiotic regimens. Lyme is a serious disease, however, and may cause the following complications:

• Improper or inadequate treatment, especially in adults, can lead to long-term bone and muscle problems and difficulties with memory, concentration, and fatigue.
• Heart involvement may occur in some patients.
• Post-treatment Lyme disease syndrome or PTLDS refers to long term symptoms like
  • Personality changes
  • Fatigue
  • Joint or muscle pain
  • Headaches
  • Hearing loss
  • Dizziness
  • Mood disturbances
  • Altered sensations (numbness or pins and needles)
  • Difficulty sleeping

Rarely, Lyme disease can lead to death, generally as a result of heart complications.