Tickpedia
Removal · field guidance

IV ceftriaxone for neuroborreliosis / cardiac Lyme

Lyme with meningitis, severe carditis (high-grade AV block), or late neurologic disease requires IV ceftriaxone 2 g daily for 14-28 days.

Steps

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  1. 01
    Suspect neuroborreliosis with severe headache, stiff neck, radicular pain, or cranial nerve palsy.
  2. 02
    Suspect Lyme carditis with palpitations, syncope, or new chest pain; an ECG may show heart block.
  3. 03
    These presentations warrant emergency department evaluation, not telehealth.
  4. 04
    Standard treatment is IV ceftriaxone 2 g once daily, typically 14-21 days for adults (up to 28 for late neurologic disease).
  5. 05
    Hospitalization is common for first-degree-or-higher AV block until the rhythm stabilizes.
  6. 06
    Outpatient infusion can sometimes complete the course at home with a PICC line.

Wild facts

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