Consider Lyme arthritis in children with marked swelling of large joints and appropriate epidemiologic history. Serum antibody testing is preferred. If synovial fluid is obtained, PCR testing may be performed in addition to serum antibody testing.
Initial treatment may consist of one of the following regimens:
Doxycycline for 28 days for children 8 years of age and older
Amoxicillin for 28 days for children of all ages
Cefuroxime for 28 days for children of all ages
Some children with Lyme arthritis may require additional oral or intravenous antibiotic treatment beyond the initial treatment course. Please refer to the 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease for specific treatment and dosing information.