Symptoms of Lyme Disease
by Amy Scholten, MPH
Lyme disease symptoms vary from person to person. It depends on the stage of the infection. Some people may not have symptoms.
These symptoms often develop 3 to 30 days after a tick bite:
A red rash known as erythema migrans (EM) may develop. It starts as a small red spot at the site of the tick bite. The rash expands over a period of days or weeks. It becomes oval-shaped. The rash often looks like a bull’s eye—a red ring surrounding a clear or bluish area with a red center. The size of the rash can range from dime-sized to the entire width of a person’s back. More than one ring may develop. Typically, the rash goes away within 4 weeks.
Many people do not have the rash right away or at all. Or they may have a red rash, without the bull's eye pattern.
Flu-like symptoms may develop. They may occur with or without the rash. They may include muscle and joint aches, headache, fever (a temperature of 100 to103°F or 37.7-39.4°C), stiff neck, swollen glands, and tiredness. These symptoms usually last about 5 to 21 days.
Early Widespread Infection
Note: Early symptoms usually happen with the first rash or within about 6 weeks of it. They may go away on their own within a few weeks or months.
Lyme disease. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/lyme-disease. Accessed November 11, 2021.
Lyme disease symptoms. Lyme Disease.org website. Available at: https://www.lymedisease.org/lyme-basics/lyme-disease/symptoms. Accessed November 11, 2021.
Ross Russell AL, Dryden MS, et.al. Lyme disease: diagnosis and management. Pract Neurol. 2018;18(6):455-464.
Signs and symptoms of untreated lyme disease. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/lyme/signs_symptoms/index.html. Accessed November 11, 2021.
Last reviewed November 2021 by EBSCO Medical Review Board David L. Horn, MD
Last Updated: 11/11/2021