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Have a mysterious-looking bug bite or rash? Don’t write it off—especially if you’ve spent a lot of time outdoors recently. It could be Lyme disease, a bacterial infection that you get from tick bites. But here’s the thing: Lyme disease might not look like a typical tick bite, according to a new research letter published in the journal Emerging Infectious Diseases.

Lyme disease is what you get when you’re bitten by a tick infected with a dangerous bacterium called Borrelia burgdorferi, which then makes its way into your bloodstream. Early signs of the disease include a rash and flu-like symptoms like fever, chills, body aches, and fatigue. If left unchecked, it can wreak havoc on your nervous system, heart, and joints, says Steven E. Schutzer, MD, professor of medicine at the University of Medicine and Dentistry of New Jersey-New Jersey Medical School.

The famous telltale sign of the disease is a skin rash that looks like a bull’s-eye—a reddish ring within a ring. But as it turns out, this may not occur or be recognized in about 30 percent of Lyme-disease cases, according to the new letter. Researchers looked at 14 patients with symptoms of early Lyme disease, but only four had the classic target-like rash. The other 10 participants’ rashes resembled insect or spider bites, dermatitis, or other skin conditions.

Mistaking Lyme disease for something else can lead to inappropriate or delayed treatment. That’s a serious problem since catching Lyme disease (and treating it) early ensures the best odds for a successful recovery, says Schutzer.

If you suspect that you’ve been bitten by a tick, hightail it to your doctor, who will help you determine the best treatment options for your specific case.

If you don’t have any issues with your central nervous system or your heart, your physician will likely give you oral antibiotics, says Schutzer. If, however, there’s evidence of neurological disease, then he or she might recommend IV therapy.

Schutzer stresses that treatment really depends on your individual case: “It needs to be a decision between the doctor and the patient,” he says, “but that means that the patient has to go to the doctor, as opposed to not doing anything.”

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