Monitoring

Patients with uncertain initial diagnosis should be followed up with convalescent phase serology in 2-4 weeks.[32]

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 nonresponsive to antibiotic treatment should be referred to a rheumatologist for further workup and appropriate treatment of other causes.

Patients with Lyme carditis, who have symptoms such as syncope, dyspnea, 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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