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What Are the Symptoms?

he first sign is usually a bull's-eye rash which starts 3 to 30 days after the bite and expands to several inches in diameter before disappearing after a few weeks. Be aware, however, that there's not always a rash, or the rash may look different than a bull's-eye. Other early symptoms — with or without the rash — are flu-like feelings of fatigue, headache, fever, sore throat, chills, or body aches.

You may also have vague pains in the joints, without swelling. In about half the patients who are not treated, this joint pain returns in about six months as painful arthritis with swelling, usually in one knee. In about 10% of these cases, Lyme arthritis becomes chronic. Some patients also experience a complex range of other symptoms, including stiff neck, headaches, sensitivity to light, memory loss, mood changes, chronic fatigue, recurring rashes, paralysis of one or both sides of the face, disruption of heart rhythm, and areas of tingling or numbness.

A complete list of possible symptoms:

• A circular, bull's-eye rash, often with a clear center, expanding to eight inches or more and lasting two to four weeks.
• Any type of rash.
• May be accompanied by flu-like symptoms such as headache, fatigue, fever, chills, sore throat, and aching muscles and joints.
• If not treated, weeks later the development of a generalized and painful kind of arthritis, with swelling in one or sometimes both knees.
• Paralysis (most often of the face), memory impairment, random areas of tingling or numbness.
• Skin sensitivities.
• Stiff neck.
• Sensitivity to light.
• Irregular heartbeat, chest pain, dizziness.
• Psychological changes, including depression.

Call Your Doctor If:

You think you may have contracted Lyme disease, especially if you notice a bull's-eye rash or if you suddenly develop knee pain and swelling without previous injury or arthritis. Delaying treatment can result in the more serious neurological symptoms that can be difficult and sometimes impossible to cure.