Monitoring

Patients with uncertain initial diagnosis should be followed up with convalescent phase serology in 2-4 weeks.[30]

After the initiation of treatment, patients with Lyme disease, including those with meningitis, should be followed up in 1-2 weeks for resolution of symptoms.

People who have removed ticks from themselves (including those who have received prophylactic antibiotics) should be monitored for signs and symptoms of tick-borne disease for up to 30 days.[25]

Patients with Lyme arthritis who have persistent or recurrent symptoms after completing an appropriate treatment course should receive parenteral antibiotics for 2-4 weeks.[25] Patients with arthritis who are non-responsive to antibiotic treatment should be referred to a rheumatologist for further work-up and appropriate treatment of other causes.

Patients with Lyme carditis, who have symptoms such as syncope, dyspnoea, or chest pain, or those who have atrioventricular block or a prolonged PR interval (greater than or equal to 300 milliseconds), should be admitted and continuously monitored in a cardiac unit.[25]

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