Signs and Symptoms of Untreated Lyme Disease

Fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes may occur in the absence of rash

Erythema migrans (EM) rash (see photos):

• Occurs in approximately 70 to 80 percent of infected persons

• Begins at the site of a tick bite after a delay of 3 to 30 days (average is about 7 days)

• Expands gradually over several days reaching up to 12 inches or more (30 cm) across

• May feel warm to the touch but is rarely itchy or painful

• Sometimes clears as it enlarges, resulting in a target or “bull’s-eye” appearance

• May appear on any area of the body

• Does not always appear as a “classic” erythema migrans rash

Severe headaches and neck stiffness

Additional EM rashes on other areas of the body

Facial palsy (loss of muscle tone or droop on one or both sides of the face)

Arthritis with severe joint pain and swelling, particularly the knees and other large joints.

Intermittent pain in tendons, muscles, joints, and bones

Heart palpitations or an irregular heart beat (Lyme carditis)

Episodes of dizziness or shortness of breath

Inflammation of the brain and spinal cord

Nerve pain

Shooting pains, numbness, or tingling in the hands or feet