Lyme disease is left untreated, it may progress in
stages from mild symptoms to serious, long-term disabilities. There are
three stages of Lyme disease: early localized, early disseminated, and late
Stage 1: Early localized infection (1 to 4 weeks)
Some people with Lyme disease have a rash
erythema migrans) at the site of the tick bite. The
rash is usually circular and it gets larger over time. Other people don't have
any symptoms in the early stages of Lyme disease and do not remember having had
a tick bite. About half the people infected with Lyme disease develop a rash
within 1 to 4 weeks.1 See a picture of a
Lyme disease rash .
For people who live in areas where Lyme
disease most often occurs-in the United States along the Atlantic coast, the
Midwest, and parts of Oregon and California-the circular rash can be a sign of
Lyme disease, especially when it appears during the summer months.
Some people with Lyme disease will have flu-like symptoms with or without
a rash. These symptoms may include:
In some cases of Lyme disease, the person does not notice
any symptoms during this stage.
Stage 2: Early disseminated infection (1 to 4 months)
If Lyme disease is
not detected and treated while early symptoms are present, or if you do not
have early symptoms that trigger the need for treatment, the infection may
affect the skin, joints,
nervous system, and heart within weeks to months after
the initial infection.
Symptoms at this stage may include:
- Being tired.
- Additional skin rashes in several places on your body that
develop as the infection spreads.
- Pain, weakness, or numbness in the arms or legs.
- Inability to control the muscles of the face (paralysis of the facial nerves).
- Recurring headaches or fainting.
- Poor memory and reduced ability to concentrate.
- Conjunctivitis (pinkeye) or sometimes damage to deep
tissue in the eyes.
- Occasional rapid heartbeats (palpitations)
or, in rare cases, serious heart problems.
Stage 3: Late persistent infections
If Lyme disease is not promptly or effectively
treated, damage to the joints, nerves, and brain may develop months or years
after you become infected (late Lyme disease). Symptoms at this
stage may include:
- Swelling and pain (inflammation)
in the joints, especially in the knees.
- Numbness and tingling in the hands, feet, or back.
- Severe fatigue.
- Partial facial nerve paralysis, which usually occurs within the
first few months after the tick bite.
- Neurologic changes, including problems with memory, mood, or
sleep, and sometimes problems speaking.
- Chronic Lyme arthritis, which causes recurring
episodes of swelling, redness, and fluid buildup in one or more joints that
last up to 6 months at a time.
Heart, nervous system, and joint symptoms may be the first
signs of Lyme disease in people who did not have a rash or other symptoms of