Southern tick-associated rash illness explained

Southern tick-associated rash illness
Synonyms:Masters' disease
Field:infectious disease

Southern tick-associated rash illness (STARI) is an emerging infectious disease related to Lyme disease that occurs in southeastern and south-central United States. It is spread by tick bites and it was hypothesized that the illness was caused by the bacteria Borrelia lonestari. However, there is insufficient evidence to declare this Borrelia strain as a causative agent.

Symptoms

Diagnosis is based on a circular "bull's-eye" rash at the site of infection called erythema chronicum migrans, which is very similar to that seen in Lyme disease. However, the symptoms of STARI are mild, and resemble influenza, with fatigue, muscle pains, and headache.[1] Fever is sometimes seen, but is not characteristic.

Causes

This illness is a tick-borne disease carried by the lone star tick Amblyomma americanum. This tick was first proposed as a possible vector of disease in 1984,[2] and the illnesses associated with the tick called "Lyme-like disease",[3] but it was not recognized to be distinct from Lyme disease until the late 1990s.[4] [1]

Several studies have failed to detect Borrelia burgdorferi, which is the causative agent of Lyme disease, in patients from the southern United States.[5] This disease may be caused by the related bacterium Borrelia lonestari,[6] [7] which is a spirochete first isolated in culture in 2004.[8] However, this conclusion is controversial since the spirochete is not detected in all cases of the syndrome,[9] which has led some authors to argue that the illness is not caused by a bacterial pathogen.[10]

Treatment

Infections are treated with antibiotics, particularly doxycycline, and the acute symptoms appear to respond to these drugs.[7] [11]

Prognosis

No serious long-term effects are known for this disease,[11] but preliminary evidence suggests, if such symptoms do occur, they are less severe than those associated with Lyme disease.[6]

See also

External links

Notes and References

  1. Kirkland KB . Erythema migrans-like rash illness at a camp in North Carolina: a new tick-borne disease? . Arch. Intern. Med. . 157 . 22 . 2635–41 . 1997 . 9531233 . 10.1001/archinte.1997.00440430117014 . Klimko TB . Meriwether RA . 3 . Schriefer . M . Levin . M . Levine . J . Mac Kenzie . WR . Dennis . DT.
  2. Schulze TL . Amblyomma americanum: a potential vector of Lyme disease in New Jersey . Science . 224 . 4649 . 601–3 . May 1984 . 6710158 . Bowen GS . Bosler EM . 3 . Lakat . MF . Parkin . WE . Altman . R . Ormiston . BG . Shisler . JK . 10.1126/science.6710158. 1984Sci...224..601S .
  3. Masters EJ, Donnell HD . Lyme and/or Lyme-like disease in Missouri . Missouri Medicine . 92 . 7 . 346–53 . July 1995 . 7651314.
  4. Masters E, Granter S, Duray P, Cordes P . Physician-diagnosed erythema migrans and erythema migrans-like rashes following Lone Star tick bites . Arch Dermatol . 134 . 8 . 955–60 . August 1998 . 9722725 . 10.1001/archderm.134.8.955. 25606594 .
  5. Philipp MT, Masters E, Wormser GP, Hogrefe W, Martin D . Serologic Evaluation of Patients from Missouri with Erythema Migrans-Like Skin Lesions with the C6 Lyme Test . Clin. Vaccine Immunol. . 13 . 10 . 1170–1 . October 2006 . 17028220 . 1595329 . 10.1128/CVI.00238-06.
  6. Masters EJ, Grigery CN, Masters RW . STARI, or Masters disease: Lone Star tick-vectored Lyme-like illness . Infect. Dis. Clin. North Am. . 22 . 2 . 361–76, viii . June 2008 . 18452807 . 10.1016/j.idc.2007.12.010.
  7. James AM, Liveris D, Wormser GP, Schwartz I, Montecalvo MA, Johnson BJ . Borrelia lonestari infection after a bite by an Amblyomma americanum tick . J. Infect. Dis. . 183 . 12 . 1810–4 . June 2001 . 11372036 . 10.1086/320721. free .
  8. Varela AS . First Culture Isolation of Borrelia lonestari, Putative Agent of Southern Tick-Associated Rash Illness . J. Clin. Microbiol. . 42 . 3 . 1163–9 . March 2004 . 15004069 . 356874 . 10.1128/JCM.42.3.1163-1169.2004 . Luttrell MP . Howerth EW . 3 . Moore . V. A. . Davidson . W. R. . Stallknecht . D. E. . Little . S. E..
  9. Wormser GP . Microbiologic Evaluation of Patients from Missouri with Erythema Migrans . Clin. Infect. Dis. . 40 . 3 . 423–8 . February 2005 . 15668867 . 10.1086/427289 . 2773674 . Masters E . Liveris D . 3 . Nadelman . R. B. . Holmgren . D. . Bittker . S. . Cooper . D. . Wang . G. . Schwartz . I..
  10. Dennis DT. . Reply to Masters. "Lyme-Like Illness Currently Deserves Lyme-Like Treatment" . Clinical Infectious Diseases . 2006 . 42 . 581–582 . 10.1086/500018 . 4 . 16421811. free .
  11. Blanton L, Keith B, Brzezinski W . Southern Tick-Associated Rash Illness: Erythema Migrans Is Not Always Lyme Disease . South. Med. J. . 101 . 7 . 759–760 . June 2008 . 18580719 . 10.1097/SMJ.0b013e31817a8b3f.

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