STARI: The Other Lyme Disease?

Abstract

Southern tick-associated rash illness (STARI) is a condition of yet unknown cause, reported primarily in the southeastern and south-central United States. The geographical location coincides with presence of the lone star tick (Amblyomma americanum). A potential role of infection with Borrelia lonestari, which could be transmitted through A. americanum as an associated zoonosis, is discussed. To date, only one report showed B. lonestari to be detected by PCR in the skin lesion of a patient with STARI, as well as in the lone star tick that had bitten the patient. Studies of STARI cases suggest several key clinical differences between this condition and Lyme disease. Being able to discern the etiology of erythema migrans would help to guide prognosis and treatment. It is unknown if chronic sequelae, such as those seen with Lyme disease, could also occur with STARI.

Clin Infect Immun. 2023;8(1):5-12
doi: https://doi.org/10.14740/cii164