By 2. Coughing, Wheezing and Sneezing
Lyme disease is caused by the bacterium Borrelia burgdorferi, which spreads through the bite of infected ticks. The infection most often begins with symptoms such as a rash, fever, or body aches rather than breathing problems.
As the bacteria spread and trigger the body’s immune response, inflammation can develop in different tissues. This widespread immune activity may sometimes irritate nearby structures, including parts of the respiratory tract. When the airways become irritated, a dry cough or mild chest tightness may occur. Wheezing can develop if airway passages narrow slightly, creating a whistling sound during breathing.
Sneezing and a runny nose are less common but may appear in some people. These respiratory symptoms are not among the most typical signs of Lyme disease. These symptoms may appear early after a tick bite as the body reacts to the bacteria. Because they resemble a mild cold, Lyme disease may be mistaken for a respiratory illness.
3. Facial Palsy
Facial palsy causes weakness or drooping on one side of the face, making the face appear uneven or sagging. This sign often appears during the early or spreading stage of Lyme disease as the infection moves beyond the initial bite site.
The condition occurs when the bacterium Borrelia burgdorferi affects the nervous system and causes inflammation around the facial nerve. The facial nerve controls facial movement and eye closure, and Lyme disease can disrupt its signals to the facial muscles. As a result, the muscles may not work properly on the affected side.
A person may have trouble smiling, blinking, or fully closing one eye. Drooling, slurred speech, or changes in taste may also occur. Some people notice numbness or mild pain near the jaw or ear before or during the onset of weakness. In certain cases, weakness can affect both sides of the face, although this is less common.
4. Tiredness
Tiredness is a common early sign of Lyme disease. It often begins days to weeks after a tick bite, when the infection starts affecting the body. This fatigue is different from normal tiredness. It reflects the body’s immune response as it works to fight the bacterial infection and may appear alongside fever, headache, or body aches.
A person may feel worn out even after a full night of sleep. Many people describe a heavy, low-energy feeling that makes everyday tasks difficult and does not improve with rest. In the early stages, this tiredness can resemble the flu.
A person may also have swollen lymph nodes or develop a skin rash. Because not everyone notices a rash, fatigue is sometimes one of the first clear signs. As the infection spreads through the bloodstream, tiredness may persist or return as the body continues reacting to the bacteria and ongoing inflammation.
5. The Bull’s Eye Rash
The bull’s eye rash is one of the most common early signs of Lyme disease. Doctors call it erythema migrans. It often appears at the site of a tick bite within 3 to 30 days of exposure and usually begins as a small red spot. Over several days, the rash slowly expands as the infection spreads through the skin.
As it grows, the center may clear, creating a ring pattern that resembles a target. Not all rashes have a clear center. Some remain solid red or develop a darker middle area. The rash is typically round or oval and can grow several inches wide. It may continue expanding for days or weeks if left untreated.
Unlike common insect bites, this rash is usually not itchy or painful, which helps distinguish it from other skin reactions. The skin may feel warm to the touch but typically does not blister or ooze. In some cases, more than one rash appears. This occurs when an infection spreads through the bloodstream, leading to secondary skin lesions elsewhere on the body. The bull’s eye rash may appear along with flu-like symptoms. A person may also experience fever, headache, muscle aches, or extreme fatigue at the same time.
6. Numbness
Numbness can appear when Lyme disease affects the nervous system. It may develop early in the infection or weeks to months later if the condition is not treated promptly. This change in sensation occurs when the infection irritates or inflames nerves outside the brain and spinal cord, a condition known as peripheral nerve involvement.
As nerve signaling becomes disrupted, normal sensation may become dulled or altered. A person may notice reduced feeling in the face, arms, legs, or hands. In some cases, the irritation follows the path of a nerve, causing numbness or unusual sensations along a specific area of the skin. Some people feel tingling or a “pins and needles” sensation.
Others notice an area of skin that feels asleep or less sensitive to touch. When nerve irritation becomes more severe, numbness may occur along with burning, sharp, or shooting pain, especially during movement or at night.
7. Swelling
Swelling is a common sign of Lyme disease. In earlier stages, swelling may appear in the lymph nodes. These small glands in the neck, armpits, and groin can become enlarged as the body responds to infection and may feel tender to the touch.
As the infection progresses, swelling may develop in the joints, especially in large joints such as the knees. The area may look puffy and feel tight compared to the opposite side. This occurs when the infection triggers inflammation inside the joint. Fluid can build up within the joint space, causing visible swelling.
The skin over the area may feel warm, though it is not always red. Pain often appears at the same time, and stiffness can make bending or walking difficult. A person might notice one knee swell for days or weeks, improve, and then swell again later. Other large joints, including the shoulders or elbows, can also be affected.
8. Neck Pain
Neck pain can appear in the early or later stages of Lyme disease. In the early stages, this symptom may develop days to weeks after a tick bite and often appears alongside flu-like symptoms. A person may also have fever, headache, or swollen lymph nodes during this time as the immune system reacts to the infection.
The discomfort often begins as stiffness that makes it hard to turn the head from side to side. Some people describe a deep ache that does not improve with rest or gentle stretching. As the infection spreads, inflammation may affect the tissues that surround the brain and spinal cord. This irritation can increase neck stiffness and discomfort.
The stiffness may make it painful to look down or bring the chin toward the chest. Some people may also develop worsening headaches or sensitivity to light when the tissues around the brain become irritated. These symptoms can signal irritation around the brain and spinal cord and require medical attention.
9. Headaches
Headaches are a common symptom of Lyme disease, especially in the early stages. They may develop days to weeks after a tick bite as the body begins reacting to the infection. Fever, fatigue, and other flu-like symptoms may appear at the same time.
The headache may feel constant and dull or present as strong pressure around the head. Some people describe it as different from their usual headaches, with a deeper or heavier sensation that does not fully ease. In some cases, the headache may come and go or gradually become more intense as the infection spreads through the body.
As Lyme disease begins to affect the nervous system, headaches can worsen and may not improve with rest or common pain relievers. This occurs when the infection triggers inflammation in the brain or surrounding tissues, increasing pressure and disrupting normal nerve signaling. Sensitivity to light, nausea, a stiff neck, or trouble concentrating may also develop as nervous system irritation increases.
10. Heart Troubles
Lyme disease can affect the heart in some people, a condition known as Lyme carditis. This usually develops weeks to months after infection as the bacteria spread through the body and reach heart tissue. The infection often affects the atrioventricular (AV) node, the part of the heart that carries electrical signals between the upper and lower chambers.
When this pathway becomes inflamed, electrical signals may slow down or become blocked. This disruption, called heart block, can range from mild rhythm changes to more serious delays in how signals travel through the heart. As the heart rhythm becomes abnormal, symptoms may appear. A person may feel lightheaded or dizzy, and some may faint suddenly due to reduced blood flow to the brain.
Others may notice shortness of breath, chest discomfort, or a racing or pounding heartbeat, especially during physical activity or sudden position changes. In some cases, heart symptoms may appear even when a person does not remember a tick bite or did not develop the typical skin rash earlier in the illness.
11. Seizures
Seizures can occur when Lyme disease spreads to the brain, a stage known as neurologic Lyme disease. Although uncommon, they may develop when the infection causes inflammation in brain tissue or the membranes surrounding the brain. A seizure happens when abnormal electrical signals suddenly occur in the brain.
This may cause rhythmic or jerking movements of the arms and legs. Some people experience staring spells in which they appear briefly disconnected or unresponsive. In more severe cases, a person may lose awareness or consciousness during the seizure. These episodes may last from a few seconds to several minutes.
After the episode, confusion may occur, making it difficult to think clearly or remember what happened. A person may also feel very tired or weak for a short time afterward. Other neurologic symptoms, such as weakness or difficulty speaking, may also occur when the brain becomes involved.
