Do You Know The Signs of Lyme?

In 2022, 62,551 Lyme disease cases were reported to Centers for Disease Control and Prevention, a rate nearly two times higher than the annual average case reports between 2017–2019. Unfortunately, because of the vague nature of its symptoms, many of those  Lyme patients were likely initially misdiagnosed with chronic fatigue, fibromyalgia, or depression.

Recognizing the signs of Lyme disease in yourself or a loved one is crucial for early diagnosis, treatment and heading off any potential progression to more severe stages.

Here’s a look at the different stages and symptoms of Lyme:

Stage 1: Early Localized Lyme Disease

• Rash: One of the earliest and most recognizable signs is a rash that appears at the site of the tick bite. The rash typically develops 3 to 30 days (typically 7 to 14 days) after the bite but in only 60 to 80% of infected persons. It often has a "bull's-eye" appearance, with a clear center and a red outer ring, and can expand to at least 2 inches in diameter but may reach up to 12 inches or more. The rash may feel warm to the touch but is rarely very itchy or very painful

• Flu-like Symptoms: Early symptoms may also include fever, chills, headache, fatigue, muscle and joint pain, and swollen lymph nodes. These symptoms can mimic those of the flu, making early diagnosis challenging.

Stage 2: Early-Disseminated Lyme Disease

• Neurological Symptoms: Occurring in 10% of cases, neurological symptoms can appear day to months after the initial tick bite. Symptoms may include numbness, pain, facial palsy (drooping on one or both sides of the face), numbness, tingling, “shooting” pain; weakness, numbness, tingling or shooting pain in the arms or legs; and meningitis-like symptoms including fever, headache, sensitivity to light, and stiff neck.

• Cardiac Symptoms: Some individuals may experience heart palpitations or an irregular heartbeat (Lyme carditis) for days or even months after infection. 

Stage 3: Late-Disseminated Lyme Disease

• Arthritis: Months to years after the infection, untreated Lyme disease can lead to severe joint pain and swelling (Lyme arthritis), most commonly in the knees but also involve the jaw. The joint may feel warm to the touch or may cause pain during movement. Joint swelling can come and go and move between joints.

• Neurological Issues: Persistent neurological symptoms may include numbness and tingling in the arms and legs (neuropathy), chronic muscle pain,  difficulty concentrating and memory loss.

If you suspect you have been bitten by a tick and develop any of the symptoms mentioned, seek medical attention promptly. Early diagnosis and treatment with antibiotics are crucial for preventing the disease from progressing to more severe stages. If a rash appears, taking a photograph for medical records can be helpful.

James Poole, MD, is a Hospitalist and Director of SVMC Inpatient Services.