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The page below is a sample from the LabCE course Tickborne Diseases. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Erythema migrans with central clearing/CDC

Erythema migrans without central clearing/CDC

Lyme Disease Stage 1: Localized Infection

The first stage of infection is frequently manifested as an erythema migrans rash. The rash occurs in approximately 90% of those infected. It begins 7-10 days after the tick bite (range: 3-30 days) and the tick must have been attached 36-48 hours for transmission to occur.
The lesion expands over days to weeks and some develop the classical central clearing appearance called the "bull's eye." Constitutional symptoms occur as a flu-like illness with lymphadenopathy, although it may be asymptomatic. Death is rare, especially at this stage.