This is the second article in Pain.com’s four-part series about lyme disease. This article discusses the signs and symptoms of lyme disease.
The symptoms of lyme disease can vary from person to person. Some people can be bitten by a tick that is infected with the Borrelia bacterium that causes lyme disease and exhibit very few symptoms, as their immune system fights off the invader before the infection can spread and cause problems. If symptoms occur, they can be mild, short-lived and resolve on their own, or they can become a more serious chronic problem. Not all people who have some lyme disease symptoms will develop chronic complications from lyme disease. Lyme disease symptoms can be classified into two categories: early localized lyme disease and disseminated lyme disease.
Early localized lyme disease is the first stage of lyme disease. Unless a person is aware that they have been bitten by a tick, diagnosis of lyme disease may be missed in this stage because most of the symptoms are general symptoms of illness that can be caused by many different conditions. A person with early localized lyme disease may feel generally ill, with a fever, chills, headache, fatigue, muscle cramps and aches. These symptoms may be confused with flu symptoms. One symptom of early localized lyme disease that is more specific to lyme disease is a type of rash called “erythema migrans.” This rash is sometimes called a “bull’s eye rash” because it resembles a target. It starts out as a small, round red area at the tick bite site and spreads outwards, leaving a ring in the middle of the rash that is not red. The rash may only be about an inch wide or it could spread to cover a large surface area on the body. This rash makes a diagnosis of lyme disease in its early stages easier, but not all people with lyme disease have this symptom. It is also harder to see on people with darker skin colors.
Disseminated lyme disease is a more progressed stage of lyme disease. It occurs when the infection spreads. There is usually a period of time in between the first and second stages of lyme disease in which symptoms do not occur, but the length of this time period varies. Symptoms of disseminated lyme disease vary depending on which organs are affected by the infection. It is important to note that no patient with lyme disease will have all of the possible symptoms of disseminated lyme disease. Some symptoms of disseminated lyme disease are a more severe continuation of the general symptoms experienced in early lyme disease, such as chronic or intense muscle pain, fever, headache and fatigue that significantly interferes with a person’s life.
When lyme disease affects the joints, arthritis can occur. The arthritis caused by lyme disease is usually asymmetrical. Joints may swell and the pain can either be temporary or a more chronic problem. Lyme disease can affect the skin, causing secondary skin rashes. These rashes are similar to the original erythema migrans rash, only they do not have to occur at the site of the original tick bite. Skin on the hands and feet can also become discolored. In some cases, benign (non-cancerous) tumors can grow on the skin.
When lyme disease affects the nervous system, this can cause paralysis of limbs, muscle weakness, neuropathy, loss of sensation in the limbs, facial paralysis, changes in smell or taste, trouble speaking, trouble swallowing and changes in hearing and vision. A person with disseminated lyme disease may have personality changes due to brain involvement. Lyme disease in the nervous system may also cause memory problems, sleep difficulties and an increased likelihood of developing depression, anxiety disorders and some other mental health conditions. Meningitis can also be a complication of lyme disease.
Lyme disease can also possibly affect liver function and cause spleen enlargement, heart arrhythmia, vasculitis, pericarditis, electrical abnormalities in the heart, pneumonia, nausea, vomiting, stomach upset, diarrhea and loss of appetite. It may be possible for a pregnant woman with lyme disease to pass the disease on to her unborn baby if her condition is not treated.
Many people who develop lyme disease may not know that they have been bitten by a tick, especially if they never develop the bull’s eye rash that is characteristic of lyme disease. Lyme disease symptoms can also mimic the symptoms of other diseases, especially in the early stages, so diagnosis of lyme disease can be difficult. If a doctor is uncertain whether a person has lyme disease, they can perform a blood test that checks for antibodies to the Borrelia bacteria that cause lyme disease. Correct diagnosis of lyme disease is an important part of successful treatment. Treatment of lyme disease is the subject of the next article in this series.