Aute (early) Lyme disease symptoms:

Rash – This rash, called erythema migrans (EM), is usually oval or circular, uniform in color and centered on the initial bite site. Although the bulls eye rash is the classic Lyme disease rash, it occurs in only 10-20% of the patients who have a rash during their illness. The bullseye rash is not the most common rash.The most common rash is oval and uniformly colored.The rash appears 2-3 days after the bite. This usually expands and clears over several weeks.

Blood tests will likely be negative during this stage of Lyme disease. If a patient has multiple rashes, this is considered later lyme and should be treated differently.One third of all Lyme disease patients never have an EM rash.

Fever, malaise, fatigue, headache, muscle and joint aches The incubation period from tick bite to the onset of symptoms is usually 1-2 weeks but it can be as long as one month. It is possible for an infected person to have no symptoms or display only one or two symptoms; this can make obtaining a correct diagnosis difficult.

Persistent (late) Lyme disease symptoms

Fatigue, muscle and joint aches, Bell’s palsy, pain, numbness, tingling or burning sensations, meningitis, tremor, muscle twitches short-term memory loss, depression, anxiety, panic attacks, hallucinations and many others. The symptoms of late Lyme disease can appear months to years from infection. Left untreated, Lyme disease can cause chronic disability, but it is rarely fatal. Cases of persistent infection have been known to linger for 20 years before being correctly diagnosed.

 Printable Symptoms Checklist to bring to your doctors apt.


The most reliable method for diagnosing Lyme disease is a thorough medical history and physical exam. The history includes details about possible tick exposure, current medical problems and a complete review of all symptoms. The physical exam includes a good general exam plus detailed dermatologic, neurologic and joint exams. The laboratory tests used to assist in the diagnosis of Lyme disease include the ELISA and Western blots. The ELISA is called the screening test; if it is positive then Western blots are done. Unfortunately, neither test is a reliable indicator of illness; test results vary between labs and within the same lab and false positives and false negatives are common. A 2003 study by CDC researchers demonstrated that the C6 ELISA, a commonly used test for Lyme disease, performed well for patients with arthritis but missed patients with acute disease and many with early or late neurologic Lyme disease. Because of these sorts of testing problems, Lyme disease must be diagnosed on clinical grounds. Lab tests may confirm a clinical diagnosis but by themselves they cannot rule the disease in or out.

  Read Understanding Lyme Tests Results, by Dr. Charles Ray Jones


The two tier testing system endorsed by the Centers for Disease Control and Prevention (CDC) has a high specificity (99%) and yields few false positives. But the tests have a uniformly miserable sensitivity (56%)—they miss 88 of every 200 patients with Lyme disease. NIH

  Read Serologic Testing in Lyme Disease by Dr. Elizabeth Maloney

Other Resources

If a patient has an EM highly suggestive of Lyme disease and recent symptom onset (<2-3 weeks), B. burgdorferi antibody tests are not recommended because of low sensitivity at this stage of infection.   Read more

Mosquitoes and fleas are not vectors of the Lyme disease agent. Some blood-feeding insects could theoretically pick up the organism if they feed on an infected small mammal host. However, they have not been shown to be able to efficiently maintain the bacteria over time or transmit the bacteria in subsequent feedings. The same holds true for American dog ticks.

Neuropsychiatric Lyme Disease



Over 90% reported that their short-term treatment had failed, resulting in chronic illness, which can have a huge impact on quality of life. Of those with chronic Lyme, 73% rated their current quality of life as fair or poor and 42% reported they had to quit working because of Lyme.