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SHOULD LYME DISEASE AFFECTING THE NERVOUS SYSTEM BE TREATED WITH ORAL OR INTRAVENOUS ANTIBIOTICS?
  1. G Selby,
  2. S J Bridges,
  3. L Hanington
  1. Musgrove Park Hospital, Taunton & Somerset NHS Trust, Taunton, UK; georginaselby@hotmail.com
  2. Musgrove Park Hospital, Taunton, UK
  3. Oxford University, Oxford, UK

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    A 10-year-old girl presents complaining of headache and muscle aches. She is diagnosed with a viral illness and sent home. Two days later she presents with a right sided facial paralysis and worsening headache. A CT scan is normal but her cerebrospinal fluid has a high lymphocyte count and a provisional diagnosis of Lyme neuroborreliosis is made, which is later confirmed on serology. The patient is commenced on a 3-week course of intravenous ceftriaxone. You wonder if there is any evidence to support managing this patient with oral antibiotics.

    Clinical question

    In children with Lyme neuroborreliosis (Lyme disease affecting the nervous system) [patient] are oral antibiotics [intervention] a comparable alternative to intravenous antibiotics [comparison] in inducing remission of symptoms [outcome]?

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    Primary sources

    PubMed: “Lyme disease AND intravenous” yielded 180 hits, four of which were relevant and in the English …

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