Symptoms by infection
What is commonly described for each of the three main tick-borne infections. They overlap heavily with each other and with many other conditions, and some symptoms are reported by patients and Lyme-literate clinicians more than they appear in standard guidelines. Those are marked.
Borrelia Lyme disease
Spread by the bite of an infected tick.
Early signs (days to weeks)
- Expanding round or oval rash at the bite (not always a bull’s-eye, and some people never see one)
- Fever and chills
- Fatigue
- Headache
- Stiff neck
- Muscle and joint aches
- Swollen lymph nodes
If it spreads (weeks to months)
- More than one rash
- Facial droop (Bell’s palsy), on one or both sides
- Severe headache with neck stiffness
- Numbness, tingling or shooting pains
- Joint and muscle pain that moves around
- Red, irritated eyes
- Palpitations, fainting or breathlessness (Lyme carditis)
Later or long-lasting
Some people have lasting fatigue, pain or thinking problems even after treatment. What causes this is still debated.
- Swollen, painful large joints, especially the knees, that flare and settle
- Numbness and tingling in the hands and feet
- Memory and concentration problems
- Mood and sleep disturbance
- Severe fatigue
Often reported by patientsNot in every guideline
- Ringing in the ears
- Ear pain
- Dizziness, vertigo or poor balance
- Blurred or double vision
- Muscle twitching and tremors
- Night sweats
- Chest pain or rib soreness
- Difficulty with speech, writing or reading
Bartonella best known as cat-scratch disease
Usually from cat scratches, bites or cat fleas. Ticks can also carry it.
Acute infection
- Bump or blister where scratched or bitten
- Swollen, tender lymph nodes, often near the scratch
- Low-grade fever
- Headache
- Fatigue
- Poor appetite
Less common, more serious
- Red, sore eye with swollen glands
- Blurred vision (inflammation at the back of the eye)
- Liver or spleen involvement
- Infection of the heart valves
- Bone infection
- Confusion or other brain involvement (encephalopathy)
Often reported in long-term infection
Researchers have found Bartonella in some people with psychiatric symptoms and skin lesions, but the evidence so far comes from small studies and larger ones are needed.
- Pain in the soles of the feet, often worst in the morning
- Shin or deep bone pain
- Red or purple streaks like stretch marks
- Skin rashes or tender lumps under the skin
- Joint pain that moves around
- Muscle twitching
- Anxiety, panic or low mood
- Irritability, anger or rage
- Obsessive thoughts
- Brain fog and poor concentration
- Insomnia
- Eye pain and light sensitivity
- Abdominal pain or gastritis
- Palpitations
- Flu-like flares that come and go
Babesia babesiosis
Spread by infected ticks, and rarely by blood transfusion. Many infections cause no symptoms at all.
Common, flu-like
- Fever and chills
- Sweats
- Headache
- Muscle and joint aches
- Fatigue and general malaise
- Loss of appetite
- Nausea
From red blood cell damage
- Anaemia: pale, tired and breathless
- Yellow skin or eyes (jaundice)
- Dark, tea-coloured urine
- Enlarged spleen or liver
- Low platelets (seen on blood tests)
Often reported by patientsNot in every guideline
- Drenching night sweats
- “Air hunger”: feeling you cannot get a full breath
- Dizziness or light-headedness
- Exercise intolerance
- Brain fog and poor concentration
- Energy that swings up and down
Severe illness
More likely with no spleen, older age or a weakened immune system.
- Severe breathing difficulty
- Low blood pressure
- Heart failure
- Kidney or liver failure
- Confusion
- Bleeding problems
A list like this cannot tell you what you have, or whether you have any of these infections. How people get tested is covered on the Testing page. Educational reference only, not medical advice.
Based on CDC and IDSA clinical descriptions, NC State research on Bartonella, and symptom reports from Lyme-literate clinicians and patient organisations.
Look up your symptoms
Search for a symptom, add it, and see which of the three infections’ lists mention it. Add as many as you like. Nothing you add is saved or sent anywhere.
This is a reference lookup, not a symptom checker. It does not diagnose, rank or score anything, and it cannot tell you what you have or how likely any infection is. Most symptoms appear on more than one list, and many other conditions cause the same symptoms. How people get tested is covered on the Testing page.
Get urgent medical help for chest pain, fainting, a very slow or irregular heartbeat, severe breathlessness, confusion, yellow skin or eyes, very dark urine, or a severe headache with a stiff neck.
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| Your symptoms | BorreliaLyme disease | Bartonella | Babesia |
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- In standard clinical descriptions
- Often reported by patients, not in every guideline
- Not listed