Lyme Disease Symptoms

The symptoms experienced by people with Lyme disease are very varied. However, the most common is erythema migrans.
Lyme Disease Symptoms

Last update: 19 August, 2021

Lyme disease is an infectious disease, transmitted by ticks, that affects a small percentage of the world’s population. It produces skin and systemic manifestations that can cause great discomfort in those affected. Are you interested in knowing the symptoms of Lyme disease? Next up, we’ll tell you.

The spirochete Borrelia spp, injected by the tick bite, is directly responsible for this pathology. Studies claim that Borrelia burgdorferi is responsible for the cases in the United States, while Borrelia afzelii and Borrelia garinii are the most common pathogens in Europe and Asia.

Common symptoms of Lyme disease

Lyme disease can present itself through a wide variety of symptoms, which will depend on the stage of the infection. It’s divided into early localized, early disseminated, and late stages. In general, its main sign is a skin rash that appears anywhere on the body, known as erythema migrans.

Similarly, general symptoms may occur. In addition, the appearance of joint alterations and signs of neurological affection is possible after weeks or months without symptoms.

Tick causes symptoms of Lyme disease.
The disease is carried by ticks, which act as vectors for the bacteria.

Migratory erythema

The eruptive skin lesions that define erythema migrans are the most common finding in the early phase of the disease. Some research affirms that this symptom appears in more than 80% of patients with Lyme disease. It usually manifests as a macula or red spot in the area of the tick bite site around 3 days later.

After several days, this skin lesion can grow gradually until it reaches a width of 30 centimeters (12 inches) or more. The expansion of the macula usually clears the central part of the lesion, giving it the appearance of a ring or shooting target. Similarly, some patients may have a dark spot with a hard or hot center to the touch.

This erythema is rarely associated with pain or itching, but prompt medical attention should be sought before its appearance. It usually remits spontaneously after 3 to 4 weeks and reappears in case of reinfection or relapse.

General manifestations

Usually, people with Lyme disease have flu-like symptoms during the early spread stage. In this sense, the following clinical manifestations can be evidenced:

  • General discomfort
  • Fever and chills
  • Headache and neck stiffness
  • Muscle pain or myalgia
  • Nausea and vomiting
  • Swelling of the lymph nodes

These nonspecific symptoms usually last for days or weeks, appearing and disappearing spontaneously. In addition, they can sometimes make diagnosis difficult if they aren’t accompanied by typical skin lesions.


Inflammation and pain in the joints are usually one of the most frequent symptoms in the late phase of untreated Lyme disease. Its appearance is frequent after several months or years from the beginning of the pathology, in more than half the cases. Arthritis usually affects the large joints, especially in the knee.

The joints may have the typical symptoms of arthritis, such as pain and warmth to the touch, and may be red. Similarly, the condition is capable of migrating from one joint to another and being recurrent in the long term.

Paralysis and weakness

Paralysis and muscle weakness are usually the result of neurological disorders that develop weeks or months after erythema migrans. Brain conditions generally include meningitis or meningoencephalitis. Studies claim that facial nerve palsy is one of the most common symptoms.

In addition, affected people may have paresthesias or abnormal sensations in the extremities, such as numbness and tingling. Motor radiculopathies cause loss of strength and impaired body movement.

Rare symptoms of Lyme disease

In some cases, people may have rare symptoms from the spread of Lyme disease through the bloodstream. These symptoms appear weeks, months, and even years after the onset of the pathology.

Cardiac alterations

Myocardial conditions can appear between the early and late dissemination stage as a result of cardiac invasion by Borrelia spp. This fact can lead to myocardial conduction disturbances and manifest with arrhythmias and atrioventricular blocks.

On rare occasions, pericarditis may occur as an effect of this disease. In these cases, the patient has severe chest pain, hypotension, respiratory distress, and an enlarged cardiac silhouette on radiographs.

Eye condition

Conjunctivitis is a rare condition in the early stages of this disease. It’s accompanied by discomfort in the eyeball, irritation, and watery eyes. On the other hand, in advanced stages, there may be ocular inflammation with damage to the uvea, cornea and iris.

Possible complications

People who don’t receive treatment for Lyme disease can develop medium and long-term side effects from multi-organ damage. Among the main complications are the following:

  • Lyme arthritis
  • Arrhythmias
  • Cardiomyopathy and pericarditis
  • Central and peripheral neuropathies
  • Bell’s palsy
  • Cognitive impairment and amnesia
  • Meningitis
  • Insomnia
Lyme arthritis.
Lyme arthritis is a complication that can appear long after an encounter with the bacteria.

When to seek medical assistance?

In most cases, people show nonspecific symptoms when infected with Borrelia spp. However, the presence of round, red lesions with a central whitish halo is a warning sign of Lyme disease. This is especially so if the person has been exposed to closed spaces or to contamination by ticks.

Similarly, seek medical assistance if the rash is accompanied by high fever and muscle aches. Early diagnosis and treatment often provide an excellent prognosis for infected people.

A rare disease with multiple complications

Lyme disease is a bacterial infection caused by the bite of ticks that carry the microorganism. Its incidence worldwide is low and predominates in specific areas during the summer and spring. However, it’s associated with a wide variety of comorbidities in the skin, joints, muscles, liver, and heart.

Similarly, it’s part of neurotropic infections, which is why it alters the central and peripheral nervous system. For this reason, being aware of the symptoms of Lyme disease and learning to identify them early is a vital preventive measure.

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