What are early symptoms of Lyme disease?

Short answer: Early Lyme disease most often causes a characteristic expanding skin rash plus flu-like symptoms. Not everyone has all features, and early antibody tests can be negative — see a clinician if you suspect Lyme.

Common early (localized) symptoms — days to a few weeks after a tick bite
- Erythema migrans (EM) rash: an expanding red patch at the bite site, often with central clearing (“bull’s-eye”) but it can also be uniformly red. Typically grows over days and is usually >5 cm. Occurs in roughly 60–80% of cases.
- Fever, chills
- Fatigue
- Headache
- Muscle and joint aches
- Swollen nearby lymph nodes

Early disseminated symptoms — days to weeks (or a few months) after infection
- Multiple EM rashes at different body sites
- Neurologic signs: facial nerve palsy (Bell’s palsy), severe headache and neck stiffness (meningitis), numbness or shooting pains
- Cardiac: palpitations, lightheadedness, fainting from varying degrees of heart block (Lyme carditis)
- Migratory joint and tendon pain, intermittent swelling

Important points
- Not everyone remembers a tick bite or develops the classic “bull’s-eye” rash.
- Blood antibody tests (ELISA + confirmatory Western blot) often remain negative in the first few weeks; a visible EM rash alone is diagnostic in endemic areas and usually treated.
- If you have a tick bite and develop a rash or the symptoms above, seek medical evaluation. Urgent care is warranted for facial weakness, fainting, chest pain, significant shortness of breath, or severe headache/stiff neck.
- Prevention: prompt, proper tick removal; daily tick checks in endemic areas; use of repellents and protective clothing.

If you want, tell me where you are (region) and whether you have a rash or a known tick bite, and I can give more specific next steps.