Consider Lyme neuroborreliosis in children who present with acute cranial neuropathies or meningitis of unknown cause with appropriate epidemiologic history. Rarely in children, Lyme disease may also cause painful radiculoneuritis, mononeuropathy multiplex or spinal cord or brain inflammation. Serum antibody testing is preferred. PCR testing or culture of blood or cerebral spinal fluid (CSF) has poor sensitivity and is not generally recommended. If CSF is obtained, it is recommended that simultaneous samples of CSF and serum are obtained for determination of the CSF:serum antibody index. Treatment for children of all ages may consist of one of the following regimens: Ceftriaxone (intravenous) for 14-21 days Doxycycline for 14-21 days Please refer to the 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease for specific treatment and dosing information.