Southern tick-associated rash illness

A putative borrelia infection causing acute manifestations similar to lyme disease, particularly erythema migrans, following the bite of the lone star tick, amblyomma americanum.

Lone Star Tick Bite

Clinical features

• A rash similar to the rash of Lyme disease has been described in humans following bites of the lone star tick, Amblyomma americanum.
• The rash may be accompanied by fatigue, fever, headache, muscle and joint pains.
• This condition has been named southern tick-associated rash illness (STARI).

Female Lone Star Tick

Cause

The cause of STARI is not known.

Erythema migrans

Symptoms

STARI rashes take many forms:

• The rash of STARI is a red, expanding “bull’s-eye” lesion that develops around the site of a lone star tick bite.
• The rash usually appears within 7 days of tick bite and expands to a diameter of 8 centimeters (3 inches) or more.
• The rash should not be confused with much smaller areas of redness and discomfort that can occur commonly at the site of any tick bite.
• Patients may also experience fatigue, headache, fever, and muscle pains.
• The saliva from lone star ticks can be irritating; redness and discomfort at a bite site does not necessarily indicate an infection.

Diagnosis

• STARI is diagnosed on the basis of symptoms, geographic location, and possibility of tick bite.
• Because the cause of STARI is unknown, no diagnostic blood tests have been developed.
• Researchers once hypothesized that STARI was caused by the spirochete, Borrelia lonestari; however, further research did not support this idea.

Treatment

• It is not known whether antibiotic treatment is necessary or beneficial for patients with STARI.
• Nevertheless, because STARI resembles early Lyme disease, physicians will often treat patients with oral antibiotics.

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