Signs and Symptoms of Lyme Disease

Signs

Lyme disease can begin with mild flu-like symptoms which typically include extraordinary fatigue. The initial symptoms have been found to occur as many as eight weeks after a tick bite. About half of patients notice a skin rash (erythema migrans) days or even weeks later. These early symptoms usually lessen or even disappear, although they may recur on a regular basis. Left untreated, a series of multi-systemic problems can then develop and worsen over time, sometimes with periods of greater intensity every three to four weeks.
Photos (left to right): 1. Deer tick, 2. Classic Bullseye, 3. Uniformly Red Lesion, 4. Blisterings Lesion, 5. Disseminated Lesions, and, 6. Blue-Red Lesion. Courtesy of lymemd.org.

Symptoms

Symptoms may include, but are not limited to:

- Fatigue
- Low grade fevers, "hot flashes" or chills
- Night sweats
- Sore throat
- Swollen glands
- Stiff neck
- Migrating arthralgias, stiffness and frank arthritis
- Myalgia
- Chest pain and palpitations
- Abdominal pain, nausea
- Diarrhea
- Sleep disturbance
- Poor concentration and memory loss
- Irritability and mood swings
- Depression
- Back pain
- Blurred vision and eye pain
- Jaw pain
- Testicular/pelvic pain
- Tinnitus
- Vertigo
- Cranial nerve disturbance (facial numbness, pain, tingling, palsy or optic neuritis)
- Headaches
- Lightheadedness
- Dizziness - Mysterious migrating symptoms that seem to come and go - Cyclical symptom

General
Flu-like symptoms including fever, fatigue, headache (mild to migraine-like), sore throat, muscle aches.

Skin
One or more erythema migrans (EM) rashes which vary in size and shape; may have concentric rings of varying shades of red, purple, or bruised looking skin, or be uniformly discolored; may be warm, smooth or bumpy to the touch; may itch; may be necrotic (crusty/oozing). Multiple rashes per bite or rashes not at site of bite are indications of disseminated disease. Later skin problems include lymphocytoma (a benign nodule or tumor) and acrodermatitis chronicia atrophicans (ACA) (discoloration/degeneration usually of the hands or feet).

Nervous System
Nerve conduction defects (weakness/paralysis of limbs, loss of reflexes, tingling sensations in the extremities); severe headaches; stiff neck; meningitis; dizziness; fainting; cranial nerve involvement (change in smell/taste; difficulty chewing, swallowing, or speaking; hoarseness or vocal cord problems; facial paralysis known as Bell's palsy; drooping shoulders; inability to turn head; double vision); abnormal brain waves or seizures; sleep disorders; cognitive changes (memory problems, confusion, disorientation, decreased concentration); behavioral changes (depression, personality changes, panic attacks); mental illness (sudden onset with no previous history of mental illness).

Heart and Blood Vessels
Conduction issues including irregular beats; atrial fibrillation; heart block; myocarditis; chest pain; vasculitis.

Lungs
Difficulty breathing; pneumonia.

Eyes
Vision changes (blindness, retinal damage, optic atrophy); red eye, conjunctivitis, seeing spots; inflammation or pain in various parts of the eyes.

Joints and Muscles
Migratory joint pain, intermittent or chronic, usually asymmetrical; swelling; TMJ and other cranial facial pain. Muscle pain, inflammation, cramps, or loss of tone.

Stomach, Intestines
Nausea; vomiting; diarrhea; loss of appetite; anorexia; unexplained weight loss or gain.