Lyme disease
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Lyme disease: Essentials
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What are the symptoms of Lyme disease?

The most common symptom of Lyme disease is a pink or red rash.

The rash spreads from the part of the body where you have been bitten by an infected tick. But not everyone gets this rash.

Early symptoms
The rash is often the first and most obvious sign of infection. It is pink or red and usually appears about one or two weeks after being bitten by an infected tick.
 
 
 
 
 
Source:
Health Protection Agency.
Lyme disease (Lyme borreliosis).
Available at http://www.hpa.org.uk/infections/topics_az/zoonoses/menu.asp (accessed on 21 September 2005).
 
 
 
 
 
1 The rash can clear in the middle, making it look like a "bull's eye." It can become very large (about the size of a dinner plate) and it may spread for months if it isn't treated.

The first symptom of Lyme disease is usually a pink or red rash.

Not everyone who is infected gets a rash.
 
 
 
 
 
Source:
Steere AC.
Lyme disease.
New England Journal of Medicine. 2001; 345: 115-125.
 
 
 
 
 
2

Early on in the infection, you may also get one or more flu-like symptoms, such as:
 
 
 
 
 
Source:
Steere AC.
Lyme disease.
New England Journal of Medicine. 2001; 345: 115-125.
 
 
 
 
 
2
 
 
 
 
 
Source:
Shapiro ED
Lyme disease.
Pediatrics in Review. 1998; 19: 147-154.
 
 
 
 
 
3
 
 
 
 
 
Source:
National Institute of Allergy and Infectious Diseases
Lyme disease: the facts, the challenge.
May 2005. Available at http://www.niaid.nih.gov (accessed on 21 May 2008).
 
 
 
 
 
4

  • Tiredness
  • Headaches
  • Fever or chills
  • Muscle pains.
If you get any of these symptoms and you think you may have been bitten by a tick, see your doctor. If you have been infected with Lyme disease, then it's best to start treatment as soon as possible.

Your doctor will ask about your symptoms and check how likely it is that you have been near animals infected with ticks. People often don't realize they have been bitten by a tick, so sometimes it can be difficult to diagnose, especially if you don't have the rash.

Later symptoms
If you have no obvious symptoms you may not realize you have an infection. After a few weeks or months, the infection can spread to other parts of your body, including the nerves and joints.

If your doctor thinks you have the later stages of Lyme disease, you may need blood tests or other tests to check that you have Lyme disease.
 
 
 
 
 
Source:
Wormser GP, Dattwyler RJ, Shapiro ED, et al.
The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: Clinical Practice Guidelines by the Infectious Diseases Society of America.
Clinical Infectious Diseases. 2006; 43: 1089-1134.
 
 
 
 
 
5

Nerve problems
You may get facial palsy.
 
 
 
 
 
Source:
Health Protection Agency.
Lyme disease (Lyme borreliosis).
Available at http://www.hpa.org.uk/infections/topics_az/zoonoses/menu.asp (accessed on 21 September 2005).
 
 
 
 
 
1 This means you lose control of some muscles in your face. It usually clears up, even without treatment.

You may get pain, numbness and difficulties with movement in some parts of your body. Doctors call it radiculopathy. It's caused by inflamed nerves and can last for months if you don't get treatment. The pain goes away quickly once you are treated.

A few people with Lyme disease get meningitis. In meningitis, the linings covering your brain and spinal column become
 
 
 
 
 
inflammation
If your skin or some other part of your body becomes red, swollen, hot or sore, we say it is inflamed. It means that your body is trying to protect you from germs, from something in your body tissues that can hurt you (like a thorn or sliver), or from things that cause allergies (allergens). Inflammation is part of the way the body heals an infection or injury.
 
 
 
 
 
inflamed. But the meningitis you get with Lyme disease is a mild form of the disease. It isn't dangerous and doesn't lead to any serious long-term problems. Lyme meningitis isn't common. One study found that about 1 in 100 children who get Lyme disease get meningitis.
 
 
 
 
 
Source:
Shapiro ED
Lyme disease.
Pediatrics in Review. 1998; 19: 147-154.
 
 
 
 
 
3

Problems with joints
If the infection affects your joints it can be painful. It's most likely to affect your knee joints.
 
 
 
 
 
Source:
National Institute of Allergy and Infectious Diseases
Lyme disease: the facts, the challenge.
May 2005. Available at http://www.niaid.nih.gov (accessed on 21 May 2008).
 
 
 
 
 
4 In a small number of people, this pain doesn't go away, and the joints become swollen and inflamed. Doctors call this Lyme arthritis.

Other problems
Lyme disease can cause problems with your heart and your liver. But these problems are rare.
 
 
 
 
 
Source:
Steere AC.
Lyme disease.
New England Journal of Medicine. 2001; 345: 115-125.
 
 
 
 
 
2
 
 
 
 
 
Source:
National Institute of Allergy and Infectious Diseases
Lyme disease: the facts, the challenge.
May 2005. Available at http://www.niaid.nih.gov (accessed on 21 May 2008).
 
 
 
 
 
4

Sources for the information on this page:
  1. Health Protection Agency.Lyme disease (Lyme borreliosis).Available at http://www.hpa.org.uk/infections/topics_az/zoonoses/menu.asp (accessed on 21 September 2005).
  2. Steere AC.Lyme disease.New England Journal of Medicine. 2001; 345: 115-125.
  3. Shapiro EDLyme disease.Pediatrics in Review. 1998; 19: 147-154.
  4. National Institute of Allergy and Infectious DiseasesLyme disease: the facts, the challenge.May 2005. Available at http://www.niaid.nih.gov (accessed on 21 May 2008).
  5. Wormser GP, Dattwyler RJ, Shapiro ED, et al.The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: Clinical Practice Guidelines by the Infectious Diseases Society of America.Clinical Infectious Diseases. 2006; 43: 1089-1134.
This information was last updated on Apr 09, 2009
BMJ Group
This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2009. All rights reserved.
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