The first symptom of Lyme disease in most people is an expanding red
skin rash (called erythema migrans or an EM rash). In about a third of people,
the rash looks like a bull's-eye, with a pale center area surrounded by a
bright red rim. The rash is often accompanied by viruslike symptoms,
including:
- Fatigue (the most common
symptom).
- Headache and stiff neck.
- Fever (which may be
high in children, but this is rare).
- Muscle and joint pain.
About 20% of people have viruslike symptoms only (no rash) or have no
symptoms at all.
If Lyme disease is not detected and treated while early symptoms are
present, or if a person never has early symptoms that trigger the need for
treatment, the infection may spread to the heart, the joints, the brain and
spinal cord (nervous system), or sites on the skin.
Heart and nervous system problems may develop weeks to months after
the initial infection, including:
- Pain, weakness, or numbness in the arms or
legs.
- A gradual inability to control the muscles of one side of the
face (paralysis of the facial nerves).
- Irregular heartbeat and
shortness of breath.
- Severe headache and stiffness in the
neck.
Damage to the joints, nerves, and brain may develop months to years
after a person becomes infected, causing:
- Swelling, pain, or redness in the
joints.
- Poor memory and reduced ability to
concentrate.
- Numbness and tingling in the hands, feet, or
back.
- Severe fatigue.