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What are the symptoms of acute Lyme disease Acute Lyme disease symptoms include: Fever Expanding red skin rash that spreads out from the bite site (it may not have the classic bullseye appearance) Fatigue Headache Muscle aches Joint pain Testing for acute Lyme disease If you develop fever, a spreading rash, facial weakness, severe headache, or flu-like symptoms within a month of a tick bite, contact your healthcare provider