The Lyme disease bacterium can infect several parts of the body, producing different symptoms at different times. Not all patients with Lyme disease will have all symptoms, and many of the symptoms can occur with other diseases as well.

One early sign of infection is a circular rash called erythema migrans or EM, which occurs at the site of the tick bite. The rash, sometimes referred to as a “bullseye” rash, expands over a period of several days, reaching up to 12 inches (30 cm) across. Most EM lesions remain red throughout or are redder in the center. Only 9% of EM lesions exhibit the central clearance of the classic bull’s eye appearance, however. The rash may be warm but is not usually painful. Some patients develop additional EM lesions in other areas of the body after several days.

It is important to note that the EM rash, though considered a “classic” sign of Lyme disease, occurs in less than half of all patients. . The disease can progress even in patients who do not develop the rash. Patients may also experience flu-like symptoms of fatigue, chills, fever, headache, muscle and joint aches, and swollen lymph nodes. In some cases, these may be the only symptoms of infection.

If left untreated, the infection may spread to other parts of the body within a few days to weeks, producing an array of discrete symptoms. These include loss of muscle tone on one or both sides of the face (called facial or “Bell’s palsy), severe headaches and neck stiffness caused by meningitis, shooting pains that may interfere with sleep, heart palpitations and dizziness caused by changes in heartbeat, and migrating joint pains. Some of these symptoms may resolve, even without treatment.

After several months, untreated or inadequately treated patients may go on to develop severe and chronic symptoms affecting many organs of the body including the brain, nerves, eyes, joints and heart. Shooting pains, numbness or tingling in the hands or feet, problems with concentration and short term memory, severe weakness, vision problems, intolerance to sound and touch, vertigo, back pain, heart block, psychiatric disorders, and swelling of joints are just some of the myriad of disabling symptoms that can occur.

The incubation period from infection to the onset of symptoms is usually 1–2 weeks, but can be much shorter (days), or much longer (months to years). Symptoms most often occur from May through September because the nymphal stage of the tick is responsible for most cases. Asymptomatic infection exists but is found in less than 7% of infected individuals in the United States. Asymptomatic infection may be much more common among those infected in Europe.

Other less common findings in acute Lyme disease include cardiac manifestations (up to 10% of patients may have cardiac manifestations including heart block and palpitations, and neurologic symptoms (neuroborreliosis may occur in up to 18%). In addition, simple altered mental status as the sole presenting symptom has been reported in early neuroborreliosis. Patients have been known to get Baker’s cysts.

From Wikipedia, the free encyclopedia

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