In about 50% of the cases a characteristic rash or lesion called erythema migrans is seen. It begins a few days to a few weeks after the bite of an infected tick. The rash generally looks like an expanding red ring. It is often described as looking like a bull's-eye with alternating light and dark rings. However, it can vary from a reddish blotchy appearance to red throughout. And can be confused with poison ivy, spider or insect bite, or ringworm. At about the same time that the rash develops, flu-like symptoms may appear with headache, sore throat, stiff neck, fever, muscle aches, fatigue and general malaise. Some people develop the flu-like illness without getting a rash.

Seek prompt medical attention if any of these symptoms appear, especially after being bitten by a tick or visiting an area where Lyme disease is common. If possible document the presence of the rash by taking a picture because it may disappear before a physician can see it. A picture in this case is worth 10,000 words!

If ignored, the early symptoms may disappear, but more serious problems can develop months to years later. The later symptoms of Lyme disease can be quite severe and chronic. Muscle pain and arthritis, usually of the large joints is common. Neurological symptoms include meningitis, numbness, tingling, and burning sensations in the extremities, Bell's palsy (loss of control of one or both sides of the face), severe pain and fatigue (often extreme and incapacitating) and depression. Heart, eye, respiratory and gastrointestinal problems can develop. Symptoms are often intermittent lasting from a few days to several months and sometimes years. Chronic Lyme disease, because of its diverse symptoms, mimics many other diseases and can be difficult to diagnose.

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