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Lyme Disease Symptoms Mayo Clinic

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Stage : Early Localized Disease

Lyme Disease: Mayo Clinic Radio

Symptoms of Lyme disease usually start 1 to 2 weeks after the tick bite. One of the earliest signs of the disease is a bulls-eye rash.

The rash occurs at the site of the tick bite, usually, but not always, as a central red spot surrounded by a clear spot with an area of redness at the edge. It may be warm to the touch, but it isnt painful and doesnt itch. This rash will gradually fade in most people.

The formal name for this rash is erythema migrans. Erythema migrans is said to be characteristic of Lyme disease. However, many people dont have this symptom.

Some people have a rash thats solid red, while people with dark complexions may have a rash that resembles a bruise.

The rash can occur with or without systemic viral or flu-like symptoms.

Other symptoms commonly seen in this stage of Lyme disease include:

Later Signs And Symptoms

If untreated, new signs and symptoms of Lyme infection might appear in the following weeks to months. These include:

  • Erythema migrans. The rash may appear on other areas of your body.
  • Joint pain. Bouts of severe joint pain and swelling are especially likely to affect your knees, but the pain can shift from one joint to another.
  • Neurological problems. Weeks, months or even years after infection, you might develop inflammation of the membranes surrounding your brain , temporary paralysis of one side of your face , numbness or weakness in your limbs, and impaired muscle movement.

What Are The Stages Of Lyme Infection

There are three stages:

  • Early localized Lyme: Flu-like symptoms like fever, chills, headache, swollen lymph nodes, sore throat, and a rash that looks like a bull’s-eye or is round and red and at least 2 inches long
  • Early disseminated Lyme: Flu-like symptoms like pain, weakness, or numbness in your arms and legs, changes in your vision, heart palpitations and chest pain, a rash , and a type of facial paralysis known as Bellâs palsy
  • Late disseminated Lyme: This can happen weeks, months, or years after the tick bite. Symptoms might include arthritis, severe fatigue and headaches, dizziness, trouble sleeping, and confusion.

About 10% of people treated for Lyme infection donât shake the disease. They may go on to have three core symptoms: joint or muscle pain, fatigue, and short-term memory loss or confusion. This is called post-treatment Lyme disease syndrome. It can be hard to diagnose because it has the same symptoms as other diseases. Plus, there isn’t a blood test to confirm it.

Experts arenât sure why Lyme symptoms donât always go away. One theory is that your body keeps fighting the infection even after the bacteria are gone, like an autoimmune disorder.

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What Are The Symptoms Of Lyme Disease

Lyme disease may evolve through several phases or stages which can overlap causing symptoms that may involve the skin, joints, heart or nervous system.

Early Lyme disease typically causes a reddish rash or skin lesion known as erythema migrans . The rash starts as a small red spot at the site of the tick bite 1 to 4 weeks after the bite. It expands over a period of days or weeks, forming a circular, triangular, or oval-shaped rash. The rash may look like a bulls eye because it appears as a red ring that surrounds a clear center area.The rash can range in size from that of a dime to the entire width of a person’s back. As infection spreads, several rashes can appear at different sites on the body.

Along with the rash, you might have a fever, headache, stiff neck, body and joint aches, fatigue and sometimes fever and swollen glands which can last from a few days to a few weeks.

If the infection goes untreated, you may develop multiple areas of rash, paralysis of facial muscles , heart block or areas of numbness or abnormal sensation .

Untreated late Lyme disease, which occurs months to a year after the initial infection, is most commonly associated with recurring episodes of swollen joints typically of large joints such as the knee. Additionally some patients may develop difficulty concentrating, which is called brain fog .

Can Lyme Disease Be Prevented

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Most people with Lyme disease become infected during the late spring, summer, and early fall when immature ticks are out feeding. Except in warm climates, few tick bites take place during winter months.

Deer ticks are most often found in wooded areas and nearby grasslands. They are especially common where the two areas merge, including neighborhood yards where deer occasionally roam. Ticks do not survive long on sunny lawns they dry out quickly and die. Although only about 1% of all deer ticks are infected, there are areas in which over 50% of the ticks carry the bacterium. The diseased ticks are often found in the U.S. Northeast and upper Midwest areas.

The following tips can help you avoid tick bites:

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Symptoms Of Lyme Disease

People with Lyme disease may react to it differently, and the symptoms can vary in severity.

Although Lyme disease is commonly divided into three stages early localized, early disseminated, and late disseminated symptoms can overlap. Some people will also present in a later stage of disease without having symptoms of earlier disease.

These are some of the more common symptoms of Lyme disease:

  • a flat, circular rash that looks like a red oval or bulls-eye anywhere on your body
  • other flu-like symptoms

These symptoms may occur soon after the infection, or months or years later.

Your child may have Lyme disease and not have the bulls-eye rash. According to an early study, results showed roughly 89 percent of children had a rash.

Lyme disease is best treated in the early stages. Treatment for early localized disease is a simple 10- to 14-day course of oral antibiotics to eliminate the infection.

Medications used to treat Lyme disease include:

  • doxycycline, amoxicillin, or cefuroxime, which are first-line treatments in adults and children
  • cefuroxime and amoxicillin, which are used to treat women who are nursing or breastfeeding

Intravenous antibiotics are used for some forms of Lyme disease, including those with cardiac or central nervous system involvement.

After improvement and to finish the course of treatment, healthcare providers will typically switch to an oral regimen. The complete course of treatment usually takes 1428 days.

What Is The Outlook For Someone With Lyme Disease

Most of the people who get Lyme disease and treated early will be fine.

Post-Lyme Syndrome

Even after proper treatment, some patients may experience lingering fatigue, achiness or headaches. This does not signify ongoing infection and will not respond to additional antibiotics. The majority of people in this group will have symptoms resolve over the next 1-6 months.

Chronic Lyme Syndrome

Chronic Lyme syndrome is a term used by some that includes the symptoms of Post-Lyme syndrome outlined above. This is a controversial topic with no accepted etiology and no proven cause or association.

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When Should You See A Doctor If You Think You Have Lyme

The rash is a pretty good indication that you may have been bitten. Take a photo of the rash and see your doctor. At this stage, treatment with antibiotics will probably work.

If you don’t have the rash but have symptoms like fatigue, fever, and headache but no respiratory symptoms like a cough, you may want to talk to your doctor.

Duration Of Lyme Disease

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Lyme disease can last a month or two or as long as months or years, depending on whether or not it is promptly or effectively treated.

When treated with antibiotics, most people recover from Lyme disease within a few weeks. If it isnt treated right way because symptoms werent present or it was misdiagnosed, the infection can affect different parts of the body and last one to four months.

Late persistent Lyme disease may develop without proper treatment. This phase can cause arthritis, fatigue, and numbness. Although it is rare, heart problems such as inflammation around the heart can occur months or years after the tick bite, notes Michigan Medicine.

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Stage : Late Disseminated Lyme Disease

Late disseminated Lyme disease occurs when the infection hasnt been treated in stages 1 and 2. Stage 3 can occur months or years after the tick bite.

This stage is characterized by:

  • arthritis of one or more large joints
  • brain disorders, such as encephalopathy, which can cause short-term memory loss, difficulty concentrating, mental fogginess, problems with following conversations and sleep disturbance
  • numbness in the arms, legs, hands, or feet

What Are The Treatments For Lyme Disease

Lyme disease is treated with antibiotics. The earlier you are treated, the better it gives you the best chance of fully recovering quickly.

After treatment, some patients may still have pain, fatigue, or difficulty thinking that lasts more than 6 months. This is called post-treatment Lyme disease syndrome . Researchers don’t know why some people have PTLDS. There is no proven treatment for PTLDS long-term antibiotics have not been shown to help. However, there are ways to help with the symptoms of PTLDS. If you have been treated for Lyme disease and still feel unwell, contact your health care provider about how to manage your symptoms. Most people do get better with time. But it can take several months before you feel all better.

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How Is Lyme Disease Treated

Nearly all people with Lyme disease can be effectively treated with antibiotics, usually doxycycline or amoxicillin. The duration of treatment depends on the stage of infection. In general, the sooner such therapy is initiated following infection, the quicker and more complete the recovery.

Pregnant women should be treated for Lyme disease as well. There is, however, no evidence that a fetus can be infected from its mother. Additionally, NO strong evidence exists to suggest miscarriages are more likely after Lyme.

What Should I Do If I Find A Tick On My Child

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Don’t panic. First Lyme disease is spread by the black-legged tick, not by the larger and more-common dog tick. The risk of developing Lyme disease after a black-legged tick bite is low, especially if the tick has been attached for a short time.

If you find a tick on your child, remove it using a fine-tipped pair of tweezers. Grasp the body of the tick and pull in an upward motion until the tick comes out. Do not squeeze or twist the ticks body. Take note of the ticks size and color, and how long you think it has been attached to your child.

If your child has been bitten by a black-legged tick that has been attached for more than 24 hours and you are in a Lyme disease endemic area, consult with your pediatrician. In some cases, your child may be prescribed antibiotics to prevent Lyme disease from developing.

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Later Symptoms Of Lyme Disease

In early disseminated Lyme disease, which occurs weeks to months after the tick bite, other symptoms may develop, including:

  • Additional erythema migrans lesions
  • Nerve pain.
  • Facial or Bell’s palsy, a paralysis or weakness in the muscles on one side of the face.
  • Lyme carditis, in which Lyme disease bacteria enter the tissues of the heart and interfere with the normal process that coordinates the beating of the heart symptoms include palpitations, chest pain, or shortness of breath.

Late disseminated Lyme disease, which develops months to years after the infection begins, may cause:

  • Arthritis with severe joint pain and swelling, especially in large joints such as the knees
  • Pain in the tendons, muscles, joints, and bones
  • Abnormal muscle movement
  • Numbness and tingling in the hands or feet
  • Cognitive problems, including issues with speech and short-term memory
  • Severe headaches and neck stiffness from meningitis

What Causes Lyme Disease

Lyme disease is caused by bacteria. In the United States, this is usually a bacterium called Borrelia burgdorferi. It spreads to humans through the bite of an infected tick. The ticks that spread it are blacklegged ticks . They are usually found in the:

  • Northeast
  • Upper Midwest
  • Pacific coast, especially northern California

These ticks can attach to any part your body. But they are often found in hard-to-see areas such as your groin, armpits, and scalp. Usually the tick must be attached to you for 36 to 48 hours or more to spread the bacterium to you.

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Ongoing Symptoms Of Lyme Disease

A few people who are diagnosed and treated for Lyme disease continue to have symptoms, like tiredness, aches and loss of energy, that can last for years.

These symptoms are often compared to fibromyalgia and chronic fatigue syndrome.

It’s not clear why this happens to some people and not others. This means there’s also no agreed treatment.

Speak to a doctor if your symptoms come back, or do not improve, after treatment with antibiotics.

The doctor may be able to offer you further support if needed, such as:

  • referral for a care needs assessment
  • telling your employer, school or higher education institution that you require a gradual return to activities
  • communicating with children and families’ social care

Page last reviewed: 05 July 2021 Next review due: 05 July 2024

Prognosis Of Lyme Disease

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People treated with antibiotics in the early stages of Lyme disease usually make a full recovery. Without treatment there can be complications that involve the joints, heart and nervous system, but these symptoms can still go away with treatment.

Although it is rare, some people develop whats called post-Lyme disease syndrome. Those individuals still have symptoms of Lyme Disease that interfere with their life even after theyve been treated, according to MedlinePlus.

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What Do You Do If There’s A Tick Under Your Skin

Use a pair of fine-tipped tweezers to remove it as soon as possible. Pull upward with steady pressure. If parts of the tick are still in your skin, try to get those with the tweezers, too. After everything is out, clean the bite area with rubbing alcohol or soap and water.

You probably wonât get infected if you remove the tick within 36 to 48 hours.

How do you throw away a tick?

Put it in soapy water or alcohol, stick it to a piece of tape, or flush it down the toilet.

A Small Bite Could Mean More

Bites from these tiny insects can sometimes transmit Lyme disease or other infections. If you or your children spend time outside, its important to regularly check for ticks on skin, clothing, and any belongings that youve carried with you. The CDCs website has great tips on preventing tick bites.

Its also important to familiarize yourself with Lyme disease so you can recognize the symptoms when you see them. This is particularly important because treating Lyme at the first onset of symptoms will help to lessen the duration of the disease and possibly reduce future complications.*

^MedExpress Urgent Care is honored to have earned The Joint Commissions Gold Seal of Approval® for Ambulatory Care Accreditation by demonstrating continuous compliance with The Joint Commissions performance standards. The Gold Seal is a symbol of quality that reflects our commitment to providing safe and quality care for our patients. If you have a quality of care or safety concern, please utilize the contact form on our website so that we may work to provide resolution. If we are unable to resolve your concerns, you may contact The Joint Commission on their website.

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Diagnosis And Management Of Lyme Disease

WILLIAM F. WRIGHT, DO, MPH DAVID J. RIEDEL, MD ROHIT TALWANI, MD and BRUCE L. GILLIAM, MD, University of Maryland, Baltimore, Maryland

Am Fam Physician. 2012 Jun 1 85:1086-1093.

Patient information: See related handout on Lyme disease, written by the authors of this article.

Lyme disease is the most common tick-borne illness in the United States. It is caused by the bacterium Borrelia burgdorferi, and is transmitted primarily by the deer tick . Following its discovery in children and adults in Lyme, Conn., in 1977,1 its incidence has increased steadily in the United States.2

SORT: KEY RECOMMENDATIONS FOR PRACTICE

Erythema migrans rash following a tick bite is the only clinical manifestation sufficient to make the diagnosis of Lyme disease in the absence of laboratory confirmation.

A = consistent, good-quality patient-oriented evidence B = inconsistent or limited-quality patient-oriented evidence C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. For information about the SORT evidence rating system, go to .

SORT: KEY RECOMMENDATIONS FOR PRACTICE

Erythema migrans rash following a tick bite is the only clinical manifestation sufficient to make the diagnosis of Lyme disease in the absence of laboratory confirmation.

What Happens At Your Appointment

lyme disease description chart

The GP will ask about your symptoms and consider any rash or recent tick bites you know about.

Lyme disease can be difficult to diagnose. It has similar symptoms to other conditions and there’s not always an obvious rash.

2 types of blood test are available to help confirm or rule out Lyme disease. But these tests are not always accurate in the early stages of the disease.

You may need to be retested if you still have Lyme disease symptoms after a negative result.

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When To See A Doctor

If you’ve been bitten by a tick and have symptoms

Only a minority of tick bites leads to Lyme disease. The longer the tick remains attached to your skin, the greater your risk of getting the disease. Lyme infection is unlikely if the tick is attached for less than 36 to 48 hours.

If you think you’ve been bitten and have signs and symptoms of Lyme disease particularly if you live in an area where Lyme disease is common contact your doctor. Treatment for Lyme disease is more effective if begun early.

See your doctor even if symptoms disappear

Visit your doctor even if signs and symptoms disappear the absence of symptoms doesn’t mean the disease is gone. Untreated, Lyme disease can spread to other parts of your body for several months to years after infection, causing arthritis and nervous system problems. Ticks can also transmit other illnesses, such as babesiosis and Colorado tick fever.

People with Lyme disease might get a characteristic bull’s-eye rash. The rash gradually spreads over a period of days and can eventually reach up to 12 inches across.

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