Manifestation | Regimens* | Adult dosing | Pediatric dosing (<18 years of age) | Duration | Comments |
Lymphadenitis | Preferred regimen: | Adjunctive therapies (needle aspiration, glucocorticoids) may be warranted in patients with severe or refractory disease.¶ | |||
Azithromycin |
|
| 5 days | ||
Alternative regimens:Δ | |||||
Clarithromycin |
|
| 7 to 10 days | ||
or | |||||
Rifampin◊ |
|
| 7 to 10 days | ||
or | |||||
Trimethoprim-sulfamethoxazole§ |
|
| 7 to 10 days | ||
Hepatosplenic disease/fever of unknown origin | Preferred regimen: | Adjunctive glucocorticoids may be warranted in patients with severe or persistent disease.¶ | |||
Rifampin◊ |
|
| Give combination regimen for 10 to 14 days | ||
plus | |||||
Azithromycin |
|
| |||
Alternative regimens: | |||||
Rifampin◊ |
|
| Give combination regimen for 10 to 14 days | ||
plus | |||||
Gentamicin¥ |
|
| |||
or | |||||
Azithromycin |
|
| 5 days | ||
Neuroretinitis | Preferred regimen: | Patients with neuroretinitis should also receive adjunctive glucocorticoids. We suggest a 6-week course of prednisone: 1 mg/kg orally once daily (maximum 80 mg per dose) for the first 2 weeks, followed by a gradual taper over the following 4 weeks. | |||
Rifampin◊ |
| Children ≥8 years of age:
| Give combination regimen for 4 to 6 weeks | ||
plus | |||||
Doxycycline‡ |
| Children ≥8 years of age:
| |||
Alternative regimens: | |||||
Rifampin◊ |
| For children <8 years of age and those unable to take doxycycline:‡
| Give combination regimen for 4 to 6 weeks | ||
plus either | |||||
Azithromycin |
| For children <8 years of age and those unable to take doxycycline:‡
| |||
or | |||||
Trimethoprim-sulfamethoxazole◊ |
| For children <8 years of age and those unable to take doxycycline:‡
| |||
Other neurologic involvement (including encephalitis) and Parinaud oculoglandular disease | Same regimens as for neuroretinitis | 10 to 14 days | Adjunctive glucocorticoids may be warranted in patients with severe or persistent disease.¶ |
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