Lyme Disease Health Article

Early localized Lyme disease

The most recognizable indicator of Lyme disease is a rash around the site of the tick bite. Often, the tick exposure has not been recognized. The eruption might be warm or itch. The rash—erythema migrans (EM)—generally develops within three to 30 days and usually begins as a round, red patch that expands outward from the tick bite. About 80 percent of patients with Lyme disease develop EM. Clearing may take place from the center out, leaving a bull's-eye effect; in some cases, the center gets redder instead of clearing. On children with dark skin, the rash may look like a bruise. Of those who develop Lyme disease, about 50 percent notice flu-like symptoms, including fatigue, headache, chills and fever, muscle and joint pain, and lymph node swelling. Many children with Lyme disease can develop neurologic symptoms within a few weeks following a tick bite. Neurologic symptoms in children with early Lyme disease include dizziness, stiff neck, unilateral or bilateral facial palsy, inflammation of brain membranes (a form of meningitis), knee and/or wrist arthralgia, tingling/numbness, sleep disturbance, and difficulties with memory, concentration, and learning.

Late disseminated disease and chronic Lyme disease

Weeks, months, or even years after an untreated tick bite, symptoms can appear in several forms, including the following:

• fatigue, forgetfulness, confusion, mood swings, irritability, numbness
• neurologic problems, such as pain (unexplained and not triggered by an injury), Bell's palsy (facial paralysis, usually one-sided but possibly on both sides), a mimicking of the inflammation of brain membranes known as meningitis fever, and severe headache
• arthritis (short episodes of pain and swelling in joints) and other musculoskeletal complaints (Arthritis eventually develops in about 60 percent of patients with untreated Lyme disease.)

In adults, less common effects of Lyme disease are heart abnormalities (such as irregular rhythm or cardiac block) and eye abnormalities (such as swelling of the cornea, tissue, or eye muscles and nerves). However, children with Lyme disease frequently complain of chest pain and have papilledema (swelling of the optic nerve). In addition, children with late-stage Lyme disease are more likely than adults to have fever and joint swelling and pain.