Table of ContentsView AllTable of ContentsCommon SymptomsRare SymptomsComplicationsWhen to See a Healthcare ProviderSummaryFrequently Asked QuestionsNext in Lyme Disease GuideHow Lyme Disease Is Treated
Table of ContentsView All
View All
Table of Contents
Common Symptoms
Rare Symptoms
Complications
When to See a Healthcare Provider
Summary
Frequently Asked Questions
Next in Lyme Disease Guide
Early common symptoms include:
If left untreated, some people may present with unusual symptoms of Lyme disease, such as heart inflammation, irregular heartbeat, weakness, pain, sensory symptoms, and problems with memory or concentration.This article discusses the signs and symptoms of Lyme disease, as well as possible complications of infection.
The first symptom of early Lyme disease is often the classic rash that most people are familiar with called erythema migrans.However, it’s important to be aware of all the symptoms of Lyme disease since they can be different for each individual.
Erythema Migrans
This circular rash occurs at the site of the tick bite, about seven to 14 days after you’ve been bitten, although it may begin as early as three days or as late as 30 days after the tick bite. Erythema migrans occurs in about 72% of people infected with Lyme disease.
Because the rash looks different depending on the person and the stage of the disease, it’s a good idea to have your primary care provider look at any suspicious rash. If you live in an area where ticks abound and/or Lyme disease is common, it’s even more important to be aware of any unusual rashes.
This erythema migrans rash may be described as:
Identifying Lyme Disease Rash From Pictures
Flu-Like Symptoms
Other Lyme disease symptoms may resemble the flu and can include:
Although these symptoms may resemble those of common viral infections, Lyme disease symptoms can persist or may come and go.
Less commonly, if Lyme disease goes untreated, the infection may spread from the bite location to other parts of the body—such as the nervous system or heart. When this happens, you may develop other symptoms and complications weeks, months, or even years after infection.
Neurological Issues
Lyme disease can affect your nervous system, causing a variety of symptoms such as:
More subtle changes have also been associated with untreated Lyme disease such as:
Nervous system problems can develop weeks, months, or even years following an untreated infection. These symptoms occur in approximately 10% to 12% of people and often last for weeks or months.
Ocular Symptoms
Lyme disease can also cause eye inflammation and visual disturbances such as:
Heart Problems
Around 1% of people with Lyme disease develop heart problems, which may indicateLyme carditis—a cause of heart block.With treatment, this condition rarely lasts more than a few days or weeks. Symptoms of Lyme carditis include:
Skin Symptoms
If left untreated, the infection can spread from the bite location to other areas of the skin. When this happens, you may develop:
Arthritis
After several months ofB. burgdorferiinfection, 30% to 60% of people not treated with antibiotics develop recurrent attacks of painful and swollen joints that last a few days to a few months—a condition known as Lyme arthritis.The arthritis can shift from one joint to another. The knee is commonly affected, but other large joints such as the shoulder, elbow, jaw, wrist, hip and ankle may also be affected.
Meningitis
WhenBorreliabacterium spreads through thelymphatic systemto the brain and spinal cord, it can lead tomeningitis. Lyme meningitis can cause fever, headache, stiff neck, and extreme sensitivity to light.
Hepatitis
Some people with Lyme disease have liver function abnormalities. Although not common, chronic infection can also lead tohepatitis(inflammation of the liver).
Skin Changes
Keep in mind that not all people have all of the classic Lyme disease symptoms, which makes it important to see your practitioner if you develop a rash or fever following a tick bite, especially if you live in or visited an area where there are a lot of Lyme disease cases. In the United States, this includes the Northeast, Mid-Atlantic, or north-central states.
Lyme Disease Doctor Discussion GuideGet our printable guide for your next doctor’s appointment to help you ask the right questions.Download PDFEmail AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
Download PDF
Email AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Sign Up
Thank you, {{form.email}}, for signing up.
There was an error. Please try again.
Even inhyperendemic areas(places where there are a lot of Lyme disease cases), the risk of developing Lyme disease is usually estimated to only be 3.5% at the most. It’s so low because even though up to 50% of ticks in endemic areas are infected with the bacteria that causes Lyme disease, most people remove ticks before the bacteria has had enough time to infect them.
Simple blood tests, which sometimes must be repeated to rule out infection, can give you and your family peace of mind.
If you do have Lyme disease, infection is normally easilytreatedwith common antibiotics. The earlier you’re treated for Lyme disease, the better, but even later stage cases usually respond well to medication.
Some people who receive treatment for Lyme disease continue to have symptoms for more than 6 months after completing their course of antibiotics. This condition is known as post-treatment Lyme disease syndrome (PTLDS). Those with PTLDS may experience fatigue, pain, brain fog, muscle aches, sensory issues, and cardiac effects. It’s still unclear why this occurs. However, symptoms usually improve over time.
Symptoms of Lyme disease can vary widely from person to person. Typical early symptoms of infection include fever, headache, chills, fatigue, and a characteristic rash called erythema migrans. If left untreated, infection can spread to other parts of the body, causing rare symptoms and serious complications. This may include heart inflammation, weakness, arthritis, sensory symptoms, meningitis, and cognitive problems.
If you develop a rash or fever following a tick bite, it’s important to see a healthcare provider right away.
Early diagnosis and treatment is vital to prevent Lyme disease from progressing through later stages—which can lead to rare but serious complications. By understanding the various signs and symptoms of Lyme disease, you will be better equipped to identify a possible infection and seek out the appropriate medical care.
What Is a Lyme Disease Test?
In some cases, yes. But people left untreated or undertreated are more likely to experience a progression of disease, called an early disseminated infection. This is when the virus spreads to the brain and other organ systems over the course of days or weeks, often causing a secondary rash and/or a cascade of neurological symptoms calledLyme neuroborreliosis.
Around 10% to 15% of untreated or undertreated people will develop neuroborreliosis, a neurological manifestation of Lyme disease. Symptoms vary from person to person and may include:Meningitis(typically mild with headache, stiff neck, and light sensitivity)Facial palsy(impairing muscles on one side of the face)Radiculopathy(causing nerve pain with weakness and abnormal sensations)Encephalitis(causing impaired movement, speech, or tremors)
Around 10% to 15% of untreated or undertreated people will develop neuroborreliosis, a neurological manifestation of Lyme disease. Symptoms vary from person to person and may include:
In up to 10% of untreated cases, Lyme disease can cause a complication called Lyme carditis that can causeheart palpitations, dizziness, shortness of breath, and fainting. In some people, this can lead tocardiomegaly(enlarged heart), heart valve dysfunction, and congestive heart failure.
If left untreated or undertreated, people may experience a further progression of disease several months after the initial infection. This stage of disease, called a late disseminated infection, can cause:Lyme arthritis(typically affecting the knee, hip, or other large joints)Chronic neuropathy(causing persistent burning, numbness, or tingling sensations)Encephalomyelitis(causing symptoms similar tomultiple sclerosis)Frank psychosis(causing symptoms similar tobipolar disorderorschizophrenia)
If left untreated or undertreated, people may experience a further progression of disease several months after the initial infection. This stage of disease, called a late disseminated infection, can cause:
The incubation period for Lyme disease is typically one to two weeks but can sometimes be shorter (several days) or longer (several months). This depends largely on the type ofBorreliabacteria and genus of tick involved.
Yes, but it is uncommon. Studies suggest that only around 7% of infected people will be entirely symptom-free.Even if symptoms develop, not everyone with Lyme disease will experience severe illness or progress to the later-stage infection. Earlydiagnosisandtreatmentare essential for preventing disease progression and complications.
Yes, With the appropriate treatment (typically 10 to 21 days of oralantibiotics), most cases will resolve without complications. Lyme disease is not fatal, and the recurrence of symptoms is rare in people who are treated. Even so, some people may take longer to recover than others and require additional treatments if the infection disseminates.
What Is Lyme Disease?
21 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Shapiro ED.Borrelia burgdorferi (Lyme disease).Pediatr Rev. 2014;35(12):500-9. doi:10.1542/pir.35-12-500Centers for Disease Control and Prevention.Lyme disease.Hu L.Patient education: Lyme disease symptoms and diagnosis (Beyond the Basics). UpToDate.Schwartz AM, Hinckley AF, Mead PS, Hook SA, Kugeler KJ.Surveillance for Lyme Disease - United States, 2008-2015. MMWR Surveill Summ. 2017 Nov 10;66(22):1-12. doi: 10.15585/mmwr.ss6622a1Aucott JN, Crowder LA, Yedlin V, Kortte KB.Bull’s-Eye and Nontarget Skin Lesions of Lyme Disease: An Internet Survey of Identification of Erythema Migrans. Dermatol Res Pract. 2012;2012:451727. doi:10.1155/2012/451727Bertholon P.Sensorineural hearing loss: a complex feature in Lyme disease.Otology & Neurotology. 2013;34(8):1543. doi:10.1097/MAO.0b013e3182a007d4Weinberg RS.Ocular involvement in Lyme disease. American Academy of Ophthalmology.Scheffold N, Herkommer B, Kandolf R, May AE.Lyme carditis–diagnosis, treatment and prognosis. Dtsch Arztebl Int. 2015;112(12):202-8. doi:10.3238/arztebl.2015.0202Centers for Disease Control and Prevention.Lyme carditis.American Academy of Dermatology Association.Signs of Lyme disease that appear on your skin.Arvikar SL, Steere AC.Diagnosis and treatment of Lyme arthritis. Infect Dis Clin North Am. 2015;29(2):269-80. doi:10.1016/j.idc.2015.02.004Centers for Disease Control and Prevention.Lyme arthritis.Centers for Disease Control and Prevention.Neurologic Lyme disease.UpToDate.Clinical manifestations of Lyme disease.Krause PJ, Bockenstedt LK. Cardiology patient pages.Lyme disease and the heart. Circulation. 2013;127(7):e451-4. doi:10.1161/CIRCULATIONAHA.112.101485Centers for Disease Control and Prevention.Post-treatment Lyme Disease syndrome.Wright WF, Riedel DJ, Talwani R, Gilliam BL.Diagnosis and management of Lyme disease.Am Fam Physician.Skar GL, Simonsen KA.Lyme disease. In:StatPearls [Internet].Halperin JJ.Chronic Lyme disease: misconceptions and challenges for patient management.Infect Drug Resist. 2015;8:119-28. doi:10.2147/IDR.S66739Crossland NA, Alvarez X, Embers ME.Late disseminated Lyme disease.Am J Pathol. 2018;188(3):672-82. doi:10.1016/j.ajpath.2017.11.005Hatchette T, Davis I, Johnston B.Lyme disease: clinical diagnosis and treatment.CCDR.2014;40(11):194-208. doi:10.14745/ccdr.v40i11a01
21 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Shapiro ED.Borrelia burgdorferi (Lyme disease).Pediatr Rev. 2014;35(12):500-9. doi:10.1542/pir.35-12-500Centers for Disease Control and Prevention.Lyme disease.Hu L.Patient education: Lyme disease symptoms and diagnosis (Beyond the Basics). UpToDate.Schwartz AM, Hinckley AF, Mead PS, Hook SA, Kugeler KJ.Surveillance for Lyme Disease - United States, 2008-2015. MMWR Surveill Summ. 2017 Nov 10;66(22):1-12. doi: 10.15585/mmwr.ss6622a1Aucott JN, Crowder LA, Yedlin V, Kortte KB.Bull’s-Eye and Nontarget Skin Lesions of Lyme Disease: An Internet Survey of Identification of Erythema Migrans. Dermatol Res Pract. 2012;2012:451727. doi:10.1155/2012/451727Bertholon P.Sensorineural hearing loss: a complex feature in Lyme disease.Otology & Neurotology. 2013;34(8):1543. doi:10.1097/MAO.0b013e3182a007d4Weinberg RS.Ocular involvement in Lyme disease. American Academy of Ophthalmology.Scheffold N, Herkommer B, Kandolf R, May AE.Lyme carditis–diagnosis, treatment and prognosis. Dtsch Arztebl Int. 2015;112(12):202-8. doi:10.3238/arztebl.2015.0202Centers for Disease Control and Prevention.Lyme carditis.American Academy of Dermatology Association.Signs of Lyme disease that appear on your skin.Arvikar SL, Steere AC.Diagnosis and treatment of Lyme arthritis. Infect Dis Clin North Am. 2015;29(2):269-80. doi:10.1016/j.idc.2015.02.004Centers for Disease Control and Prevention.Lyme arthritis.Centers for Disease Control and Prevention.Neurologic Lyme disease.UpToDate.Clinical manifestations of Lyme disease.Krause PJ, Bockenstedt LK. Cardiology patient pages.Lyme disease and the heart. Circulation. 2013;127(7):e451-4. doi:10.1161/CIRCULATIONAHA.112.101485Centers for Disease Control and Prevention.Post-treatment Lyme Disease syndrome.Wright WF, Riedel DJ, Talwani R, Gilliam BL.Diagnosis and management of Lyme disease.Am Fam Physician.Skar GL, Simonsen KA.Lyme disease. In:StatPearls [Internet].Halperin JJ.Chronic Lyme disease: misconceptions and challenges for patient management.Infect Drug Resist. 2015;8:119-28. doi:10.2147/IDR.S66739Crossland NA, Alvarez X, Embers ME.Late disseminated Lyme disease.Am J Pathol. 2018;188(3):672-82. doi:10.1016/j.ajpath.2017.11.005Hatchette T, Davis I, Johnston B.Lyme disease: clinical diagnosis and treatment.CCDR.2014;40(11):194-208. doi:10.14745/ccdr.v40i11a01
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Shapiro ED.Borrelia burgdorferi (Lyme disease).Pediatr Rev. 2014;35(12):500-9. doi:10.1542/pir.35-12-500Centers for Disease Control and Prevention.Lyme disease.Hu L.Patient education: Lyme disease symptoms and diagnosis (Beyond the Basics). UpToDate.Schwartz AM, Hinckley AF, Mead PS, Hook SA, Kugeler KJ.Surveillance for Lyme Disease - United States, 2008-2015. MMWR Surveill Summ. 2017 Nov 10;66(22):1-12. doi: 10.15585/mmwr.ss6622a1Aucott JN, Crowder LA, Yedlin V, Kortte KB.Bull’s-Eye and Nontarget Skin Lesions of Lyme Disease: An Internet Survey of Identification of Erythema Migrans. Dermatol Res Pract. 2012;2012:451727. doi:10.1155/2012/451727Bertholon P.Sensorineural hearing loss: a complex feature in Lyme disease.Otology & Neurotology. 2013;34(8):1543. doi:10.1097/MAO.0b013e3182a007d4Weinberg RS.Ocular involvement in Lyme disease. American Academy of Ophthalmology.Scheffold N, Herkommer B, Kandolf R, May AE.Lyme carditis–diagnosis, treatment and prognosis. Dtsch Arztebl Int. 2015;112(12):202-8. doi:10.3238/arztebl.2015.0202Centers for Disease Control and Prevention.Lyme carditis.American Academy of Dermatology Association.Signs of Lyme disease that appear on your skin.Arvikar SL, Steere AC.Diagnosis and treatment of Lyme arthritis. Infect Dis Clin North Am. 2015;29(2):269-80. doi:10.1016/j.idc.2015.02.004Centers for Disease Control and Prevention.Lyme arthritis.Centers for Disease Control and Prevention.Neurologic Lyme disease.UpToDate.Clinical manifestations of Lyme disease.Krause PJ, Bockenstedt LK. Cardiology patient pages.Lyme disease and the heart. Circulation. 2013;127(7):e451-4. doi:10.1161/CIRCULATIONAHA.112.101485Centers for Disease Control and Prevention.Post-treatment Lyme Disease syndrome.Wright WF, Riedel DJ, Talwani R, Gilliam BL.Diagnosis and management of Lyme disease.Am Fam Physician.Skar GL, Simonsen KA.Lyme disease. In:StatPearls [Internet].Halperin JJ.Chronic Lyme disease: misconceptions and challenges for patient management.Infect Drug Resist. 2015;8:119-28. doi:10.2147/IDR.S66739Crossland NA, Alvarez X, Embers ME.Late disseminated Lyme disease.Am J Pathol. 2018;188(3):672-82. doi:10.1016/j.ajpath.2017.11.005Hatchette T, Davis I, Johnston B.Lyme disease: clinical diagnosis and treatment.CCDR.2014;40(11):194-208. doi:10.14745/ccdr.v40i11a01
Shapiro ED.Borrelia burgdorferi (Lyme disease).Pediatr Rev. 2014;35(12):500-9. doi:10.1542/pir.35-12-500
Centers for Disease Control and Prevention.Lyme disease.
Hu L.Patient education: Lyme disease symptoms and diagnosis (Beyond the Basics). UpToDate.
Schwartz AM, Hinckley AF, Mead PS, Hook SA, Kugeler KJ.Surveillance for Lyme Disease - United States, 2008-2015. MMWR Surveill Summ. 2017 Nov 10;66(22):1-12. doi: 10.15585/mmwr.ss6622a1
Aucott JN, Crowder LA, Yedlin V, Kortte KB.Bull’s-Eye and Nontarget Skin Lesions of Lyme Disease: An Internet Survey of Identification of Erythema Migrans. Dermatol Res Pract. 2012;2012:451727. doi:10.1155/2012/451727
Bertholon P.Sensorineural hearing loss: a complex feature in Lyme disease.Otology & Neurotology. 2013;34(8):1543. doi:10.1097/MAO.0b013e3182a007d4
Weinberg RS.Ocular involvement in Lyme disease. American Academy of Ophthalmology.
Scheffold N, Herkommer B, Kandolf R, May AE.Lyme carditis–diagnosis, treatment and prognosis. Dtsch Arztebl Int. 2015;112(12):202-8. doi:10.3238/arztebl.2015.0202
Centers for Disease Control and Prevention.Lyme carditis.
American Academy of Dermatology Association.Signs of Lyme disease that appear on your skin.
Arvikar SL, Steere AC.Diagnosis and treatment of Lyme arthritis. Infect Dis Clin North Am. 2015;29(2):269-80. doi:10.1016/j.idc.2015.02.004
Centers for Disease Control and Prevention.Lyme arthritis.
Centers for Disease Control and Prevention.Neurologic Lyme disease.
UpToDate.Clinical manifestations of Lyme disease.
Krause PJ, Bockenstedt LK. Cardiology patient pages.Lyme disease and the heart. Circulation. 2013;127(7):e451-4. doi:10.1161/CIRCULATIONAHA.112.101485
Centers for Disease Control and Prevention.Post-treatment Lyme Disease syndrome.
Wright WF, Riedel DJ, Talwani R, Gilliam BL.Diagnosis and management of Lyme disease.Am Fam Physician.
Skar GL, Simonsen KA.Lyme disease. In:StatPearls [Internet].
Halperin JJ.Chronic Lyme disease: misconceptions and challenges for patient management.Infect Drug Resist. 2015;8:119-28. doi:10.2147/IDR.S66739
Crossland NA, Alvarez X, Embers ME.Late disseminated Lyme disease.Am J Pathol. 2018;188(3):672-82. doi:10.1016/j.ajpath.2017.11.005
Hatchette T, Davis I, Johnston B.Lyme disease: clinical diagnosis and treatment.CCDR.2014;40(11):194-208. doi:10.14745/ccdr.v40i11a01
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
