Early Symptoms of Lyme Disease

The first sign of infection is usually a circular rash called erythema migrans, or EM. This rash occurs in approximately 70-80 percent of people infected with Lyme disease and begins at the site of the tick bite that caused the infection. Usually, the rash appears after a delay of 3-30 days from when the bite occurred. A distinctive feature of the EM rash is that it gradually expands over a period of several days, reaching up to 12 inches (30 cm) across. The center of the rash may become clear as it enlarges, resulting in a bull's-eye appearance. It may be warm, but it usually isn't painful. Some patients develop additional EM rashes in other areas of the body after several days. Patients can also experience other early symptoms of Lyme disease, including:

 

In some cases, these may be the only symptoms of infection.