The signs and symptoms of Lyme disease vary and usually appear in stages.

Early signs and symptoms

A small, red bump often appears at the site of a tick bite or tick removal and resolves over a few days. This is normal after a tick bite and does not indicate Lyme disease.

However, these signs and symptoms may occur within a month after you’ve been infected:

Rash. From 3 to 30 days after an infected tick bite, an expanding red area might appear that sometimes clears in the center, forming a bull’s-eye pattern. The rash (erythema migrans) expands slowly over days and can spread to 12 inches (30 centimeters) across. It is typically not itchy or painful. Erythema migrans is one of the hallmarks of Lyme disease. Some people develop this rash at more than one place on their bodies.
Flu-like symptoms. Fever, chills, fatigue, body aches and a headache may accompany the rash.
Later signs and symptoms

If untreated, new signs and symptoms of Lyme infection might appear in the following weeks to months. These include:

Erythema migrans appearing in other areas of your body.
Joint pain. Bouts of severe joint pain and swelling are especially likely to affect your knees, but the pain can shift from one joint to another.
Neurological problems. Weeks, months or even years after infection, you might develop inflammation of the membranes surrounding your brain (meningitis), temporary paralysis of one side of your face (Bell’s palsy), numbness or weakness in your limbs, and impaired muscle movement.
Less common signs and symptoms

Several weeks after infection, some people develop:

Heart problems, such as an irregular heartbeat. Heart problems rarely last more than a few days or weeks.
Eye inflammation.
Liver inflammation (hepatitis).
Severe fatigue.
When to see a doctor

If you’ve been bitten by a tick and have symptoms

Only a minority of blacklegged tick bites leads to Lyme disease. The longer the tick remains attached to your skin, the greater your risk of getting the disease. Lyme infection is unlikely if the tick is attached for less than 36 to 48 hours.

If you think you’ve been bitten and have signs and symptoms of Lyme disease — particularly if you live in an area where Lyme disease is prevalent — contact your doctor. Treatment for Lyme disease is more effective if begun early.

See your doctor even if symptoms disappear

It’s important to consult your doctor even if signs and symptoms disappear — the absence of symptoms doesn’t mean the disease is gone. Left untreated, Lyme disease can spread to other parts of your body from several months to years after infection, causing arthritis and nervous system problems.

Lyme disease is best treated in the early stages. Early treatment is a simple 14 to 21 day course of oral antibiotics. This can eliminate all traces of infection. Medications used to treat Lyme disease are:

doxycycline for adults and children older than 8 years old
cefuroxime and amoxicillin for adults, younger children, and women who are nursing or breast-feeding
Persistent or chronic Lyme disease is treated with intravenous antibiotics for a period of 14 to 21 days. That eliminates infection. However, improvement of symptoms occurs more slowly.

It’s unknown why symptoms, like joint pain, continue after the bacteria have been destroyed. Some doctors believe that persistent symptoms occur in people who are prone to autoimmune disease.

Doxycycline Side Effects

Oral Capsule
Side effects that you should report to your doctor or health care professional as soon as possible:

allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
difficulty breathing
fever
itching in the rectal or genital area
pain on swallowing
redness, blistering, peeling or loosening of the skin, including inside the mouth
severe stomach pain or cramps
unusual bleeding or bruising
unusually weak or tired
yellowing of the eyes or skin
Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

diarrhea
loss of appetite
nausea, vomiting
Cefuroxime Side Effects

Oral Tablet
More Common Side Effects

The more common side effects that can occur with use of cefuroxime include:

diarrhea
nausea
vomiting
Jarisch/Herxheimer reaction. This is a short-term reaction seen after antibiotic treatment for certain diseases. Symptoms can include fever, chills, or muscle pain.
If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

Allergic reactions. Symptoms can include:
hives
trouble breathing
swelling of your face, lips, tongue, or throat
Amoxicillin Side Effects

Chewable Tablet
Side effects that you should report to your doctor or health care professional as soon as possible:

allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
breathing problems
dark urine
redness, blistering, peeling or loosening of the skin, including inside the mouth
seizures
severe or watery diarrhea
trouble passing urine or change in the amount of urine
unusual bleeding or bruising
unusually weak or tired
yellowing of the eyes or skin
Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

dizziness
headache
stomach upset
trouble sleeping