The rash has an outer red ring with a partial clearing in the center with slowly expands up to 20 inches in diameter. Other symptoms in this stage include fatigue, fever, chills, headache, sore throat, sore and aching muscles and joints and swollen glands. Heart symptoms also occur in 6-10 percent of Lyme disease patients. The third stage typically involves the onset of arthritis that generally occurs within two months by not more than two years after the onset of the rash. Attacks of arthritis may last from a few days to a few weeks at a time and primarily affect the knees and other large joints.
Some patients also suffer from sleepiness, loss of memory, mood swings and an inability concentrate.