Patients with uncertain initial diagnosis should be followed up with convalescent phase serology in 2-4 weeks.[30]Centers for Disease Control and Prevention. Recommendations for test performance and interpretation from the Second National Conference on Serologic Diagnosis of Lyme Disease. MMWR Morb Mortal Wkly Rep. 1995 Aug 11;44(31):590-1.
http://www.cdc.gov/mmwr/preview/mmwrhtml/00038469.htm
http://www.ncbi.nlm.nih.gov/pubmed/7623762?tool=bestpractice.com
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]Lantos PM, Rumbaugh J, Bockenstedt LK, et al. Clinical practice puidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 guidelines for the prevention, diagnosis and treatment of Lyme disease. Clin Infect Dis. 2021 Jan 23;72(1):e1-48.
https://academic.oup.com/cid/article/72/1/e1/6010652
http://www.ncbi.nlm.nih.gov/pubmed/33417672?tool=bestpractice.com
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]Lantos PM, Rumbaugh J, Bockenstedt LK, et al. Clinical practice puidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 guidelines for the prevention, diagnosis and treatment of Lyme disease. Clin Infect Dis. 2021 Jan 23;72(1):e1-48.
https://academic.oup.com/cid/article/72/1/e1/6010652
http://www.ncbi.nlm.nih.gov/pubmed/33417672?tool=bestpractice.com
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]Lantos PM, Rumbaugh J, Bockenstedt LK, et al. Clinical practice puidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 guidelines for the prevention, diagnosis and treatment of Lyme disease. Clin Infect Dis. 2021 Jan 23;72(1):e1-48.
https://academic.oup.com/cid/article/72/1/e1/6010652
http://www.ncbi.nlm.nih.gov/pubmed/33417672?tool=bestpractice.com