Additional Study Information: Why do some patients recover quickly after Lyme disease while others develop chronic symptoms? To answer this question, we need to enroll patients at different stages of illness -- early at the initial infection when it affects the skin, joints, nervous system or heart, and later as well to see who has recovered and who has persistent symptoms. Some have only a mild illness associated with the rash. Others are quite ill and may not be sure when they were infected. We follow each patient carefully over 2 years. During this interval, we collect blood and conduct objective assessments of functioning and symptoms. The patient samples are then probed for different reasons -- to develop new diagnostic tests, to identify biomarkers that can inform treatment decisions, to clarify why some patients still have symptoms while others recover fully. Patients can find it helpful to meet with the doctor at the Lyme Center and to be carefully assessed. By participating in this study, patients are helping the national effort to help improve the care of patients with Lyme disease.