Treatment of Lyme Neuroborreliosis in Children Presenting with Encephalomeningitis Symptoms

This protocol is for children diagnosed with Lyme neuroborreliosis who present with symptoms of encephalomeningitis — including vomiting or dysphagia — that prevent reliable oral administration and require intravenous initiation of treatment.

The key defining features are pediatric age and active encephalomeningitis symptoms. Vomiting or dysphagia in a child with Lyme neuroborreliosis creates a practical barrier to oral therapy at the outset, establishing the need for an IV approach from the start.

Management is initiated intravenously, with a third-generation cephalosporin used first. Once the encephalomeningitis symptoms have resolved, treatment transitions to an oral agent. The complete sequencing, agent selection, and treatment duration are available in the full structured protocol.