What are the signs and symptoms of the infection?

Early local Lyme disease often starts with a mild flu-like illness. The person may complain of the following symptoms:

The most obvious sign of Lyme disease is the bull's-eye rash, commonly at the site of the tick bite. The rash may begin the day of the bite, or up to 30 days later. It starts as a red, circular lesion, which may feel hot and itchy. As it gets bigger, the center often clears. The skin looks normal in the middle, making the lesion resemble a bull's-eye on a dartboard.

The lesion may grow to over 20 inches in diameter. Within a few days, more lesions may erupt. In 3 to 4 weeks, the lesions are replaced by small red blotches, which may continue for several weeks.

Lyme disease may spread to other body systems, causing disseminated Lyme disease. General symptoms of disseminated Lyme disease include:

Depending on the body systems involved, disseminated Lyme disease may also cause:

These symptoms tend to come and go over a number of weeks if the person is not treated.

Weeks to years later, frank, or unmistakable, arthritis can occur, with marked swelling of the joints. Recurrent attacks can lead to chronic arthritis, with severe joint damage.