A bullseye rash erythema migrans following a tick bite is a classic and highly suggestive sign of Lyme Disease, but it is not always present. Not everyone develops the rash, and some people may have atypical or no skin signs at all. Additionally, a negative blood test at the time of initial presentation does not completely rule out Lyme Disease, especially if tested early.

In your case, since the rash occurred 7 years ago and subsequent tests have ruled out Lyme Disease, it is unlikely that active Lyme Disease is contributing now. However, the history of tick exposure and rash is important and should be considered in your overall clinical evaluation.

Regarding your current symptoms and testing suggesting possible Multiple Sclerosis MS, its essential to differentiate between these conditions. MS and Lyme Disease can have overlapping neurological symptoms, but they are distinct diagnoses. Your healthcare team will consider all your clinical findings, history, and test results to arrive at the correct diagnosis.

If you have ongoing concerns or new symptoms, I recommend discussing them thoroughly with your neurologist or infectious disease specialist for further assessment.

Hello, The rash often associated with early Lyme disease can be associated with other conditions, including tick bite hypersensitivity reaction, southern tickassociated rash illness STARI, nummular eczema, granuloma annulare, and tinea corporis. So it's possible your rash was not due to Lyme disease. Also Lyme disease testing is not that great, which is why repeat testing is often recommended if Lyme disease is suspected. If you had a spinal tap, then the testing for Multiple Sclerosis is different than the Lyme disease testing performed on the spinal fluid. Also I will assume you had an MRI of the brain and spinal cord if you may have Multiple Sclerosis. Again the MRI imaging results will be a bit different for those conditions. Understand that no test is perfect. Your symptoms are consistent with Multiple Sclerosis other than the joint pain, which is a bit atypical and could actually be indicative of Lyme disease as well as some other conditions such as neurosarcoidosis. If your vision problems were intermittent episodes of double vision, that is classic for Multiple Sclerosis.

Based on your history tick EM rash, you very likely had Lyme disease. If it was untreated, neurologic sequelae are possible even years later, though this is rare. You deserve a second opinion, ideally with both A Lymeliterate infectious disease doctor A neurologist familiar with LymeMS overlap.

It is highly suspicious for Lyme disease, but not pathognomonic.