Southern tick-associated rash illness

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  • STARI (Southern tick-associated rash illness)
  • Transmitted by lone star tick (Amblyomma americanum)
    • female tick has single white dot or "lone star" on its back, aggressive feeders
  • May be caused by spirochete Borrelia lonestari
  • Midwest and Mid-Atlantic states

Clinical Features

  • Resembles Lyme disease in rash, constitutional symptoms, time course
  • May have delayed anaphylaxis (3-6h) to red meat from IgE Ab to glycoprotein in meat of mammals, w/ negative allergy skin test

Differential Diagnosis


  • No testing available


  • 10d doxycycline or amoxicillin
  • No evidence this is beneficial, but commonly given


  • Home

See Also

External Links


  1. Hall J, Khan Sajid Small Bugs with Big Bites, EM Resident Oct/Nov 2014 Vol 4:5; 10