Lyme disease, a bacterial infection carried by ticks, is divided into three stages. They are known as early localized, early disseminated, and late disseminated. The stages can overlap, and not all stages are seen in all patients, but in general the signs and symptoms of each stage can include:

  1. Early localized (1 to 4 weeks)
    • Expanding circular red rash, often described as target-shaped
    • Low energy
    • Headache with stiff neck
    • Fever and chills
    • Muscle and joint pain
    • Swollen lymph nodes
  2. Early disseminated (1 to 4 months)
    • Widening rash, further rashes
    • Pain, numbness, or weakness in the extremities
    • Recurring headaches or fainting
    • Poor memory or ability to concentrate
    • Pink eye (conjunctivitis) or deeper eye damage
    • Pain, redness, swelling in knee and other large joints
    • Fast heartbeats or more serious heart disease
  3. Late disseminated (months to years, may be first symptoms in patients not exhibiting rash)
    • Arthritis in knee or other joints
    • Numbness and tingling in hands, feet, or back
    • Tiredness
    • Weak facial muscles
    • Insomnia, mood, memory, or speaking
    • Heart problems, including pericarditis, inflammation of outer covering of heart

Note that late disseminated Lyme is rare and should not be confused with something called ‘Chronic Lyme’, which is not based on any medical or scientific evidence and is a condition which does not exist in medicine.

Treatment should be started early in the course of the disease as possible. It is aimed at eradicating the bacteria Borrelia. Doxycycline, a form of the antibiotic tetracycline, is usually the first drug of choice for adults and children over 8 years of age. Children, pregnant or breast-feeding women, and adults allergic to tetracycline are treated with amoxicillin (in the penicillin family), or cefuroxime. Oral antibiotics are given for 14 to 21 days. If the brain or spinal cord are affected, a 14 to 28 day course of IV antibiotics may have to be administered.

Where to get treated for Lyme disease?

Most primary care doctors and urgent care clinics will be able to treat early localized and early disseminated Lyme. If you do not have access to a primary care doctor on a short notice, QuickMD can help you get treated as well. Our doctors can prescribe you antibiotics via phone or video—fully remote—and send the prescription to the pharmacy of your choice.

Although Lyme disease is commonly divided into three stages — early localized, early disseminated, and late disseminated

Stages of Lyme Disease: (Stage 1-3 with symptoms and treatment)