Symptoms:

Symptoms of early localized Lyme disease (Stage 1) begin days or weeks after infection. They are similar to the flu and may include:

• Body-wide itching
• Chills
• Fever
• General ill-feeling
• Headache
• Light-headedness or fainting
• Muscle pain
• Stiff neck

There may be a "bull's eye" rash, a flat or slightly raised red spot at the site of the tick bite. Often there is a clear area in the center. It can be quite large and expanding in size.

Symptoms may come and go. Untreated, Lyme disease can spread to the brain, heart, and joints.

Symptoms of early disseminated Lyme disease (Stage 2) may occur weeks to months after the initial tick bite. They may include:

• Paralysis or weakness in the muscles of the face
• Muscle pain and pain or swelling in the knees and other large joints
• Heart problems, such as skipped heartbeats (palpitations)

Symptoms of late disseminated Lyme disease (Stage 3) can occur months or years after the initial infection. The most common symptoms are muscle and joint pain. Other symptoms may include:

• Abnormal muscle movement
• Muscle weakness
• Numbness and tingling
• Speech problems

Signs and tests:

A blood test can be done to check for antibodies to the bacteria that cause Lyme disease. The most commonly used is the ELISA for Lyme disease test. A western blot test is done to confirm ELISA results.

In areas where Lyme disease is more common, your health care provider may be able to diagnose early disseminated Lyme disease (Stage 1) without doing any lab tests.

Other tests that may be done, when the infection has become more widespread, include:

• Electrocardiogram
• Echocardiogram to look at the heart
• Spinal tap (lumbar puncture to examine spinal fluid
• MRI of the brain