In 60-80 percent of cases, a rash resembling a bull’s eye or solid patch, about two inches in diameter, appears and expands around or near the site of the bite. Sometimes, multiple rash sites appear. The early stage of Lyme disease is usually marked by one or more of the following symptoms: chills and fever, headache, fatigue, stiff neck, muscle and/or joint pain, and swollen glands. If Lyme disease is unrecognized or untreated in the early stage more severe symptoms may occur. As the disease progresses, severe fatigue, a stiff aching neck, and tingling or numbness in the arms and legs, or facial paralysis can occur. The most severe symptoms of Lyme disease may not appear until weeks, months or years after the tick bite. These can include severe headaches, painful arthritis, swelling of the joints, and heart and central nervous system problems.