Early signs and symptoms usually appear 3–30 days after the tick bite and can include:
- Characteristic rash: An erythema migrans (EM) rash is the most common sign of Lyme disease, occurring in 70–80% of cases and generally appearing around seven days after the tick bite. The rash may feel warm but is usually not itchy or painful. It expands gradually over several days reaching up to 30 cm or more in size, sometimes clearing as it enlarges, resulting in a target or “bulls-eye” appearance.
- Fever and/or chills
- Headache
- Fatigue
- Muscle and joint aches
- Swollen lymph nodes
Later signs and symptoms of Lyme disease may show up weeks to months after the tick bite and can include:
- Severe headaches and neck stiffness
- More EM rashes
- Facial palsy (loss of muscle tone on one or both sides of the face)
- Arthritis causing severe joint pain and swelling
- Intermittent pain in tendons, muscles, joints, and bones
- Irregular heart beat
- Shortness of breath or dizzy episodes
- Shooting pain, numbness, or tingling in the hands or feet