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J Pediatric Infect Dis Soc. 2018 Aug 28. doi: 10.1093/jpids/piy072. [Epub ahead of print]

Oral Management for Pediatric Lyme Meningitis.

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Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, Pennsylvania.
Richard K. Mellon Institute for Pediatric Research, Department of Pediatrics, University of Pittsburgh School of Medicine, Pennsylvania.



Guidelines for pediatric Lyme meningitis recommend treatment with parenteral therapy [1, 2]. Adult studies suggest that Lyme meningitis can be successfully treated with oral therapy. Our objective was to evaluate the clinical response, side effects and outcome of oral therapy for Lyme meningitis in the pediatric population compared with parenteral therapy in an area endemic for Lyme disease.


We conducted a case series chart review from January 2012 to May 2017 of pediatrics patient diagnosed and treated for Lyme meningitis. We recorded clinical presentation, laboratory values, antimicrobial therapy and follow up after therapy to compare the efficacy of oral versus parenteral route of therapy.


We identified 38 patients diagnosed with Lyme meningitis. Thirty-two patients were discharge with exclusively oral therapy with: doxycycline and amoxicillin. We had only 2 patients developed potential adverse effects from oral doxycycline therapy. All patients treated with oral antibiotics had resolution of symptoms on follow up appointments.


Oral therapy for Lyme meningitis yields no serious adverse events, was well tolerated and showed resolution of symptoms.


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