A patient arrives in the ER worried about a strange “bulls-eye” rash on their le

Question

A patient arrives in the ER worried about a strange “bulls-eye” rash on their leg. What tick-borne disease did the come into contact with? What other immediate or long-term symptoms might they eventually display? What kind of treatment would you recommend?

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Explanation / Answer

The given sign in the patient is indicative of Southern Tick-Associated Rash Illness shortly called as STARI or Master's disease.

It has more prevalence in South eastern and South central United States and an emerging infection which is closely related to the Lyme Disease.

Tick responsible: It is transmitted from the bite of tick called lone Star ticks namely Ambylomma americanum which serves as a vector. Some studies also suggests that bacterium, Borrelia lonestari, a spirochete is also responsible for this disease although it is not evident in all the cases. On the other hand, Lyme disease is caused by Borrelia burgdorferi.

Immediate or long term symptoms: A characteristic Bull's eye rash is seen at the site of infection called erythema chronicum migrans is observed which is quite similar to Lyme disease. The onset of skin lesions is very quick in STARI, and multiple lesions are absent in STARI when compared to Lyme disease

Symptoms are very mild for Southern Tick-Associated Rash Illness when compared to Lyme disease. The common symptoms include Influenza like symptoms, fatigue, muscle pains and headache. Fever is also observed in certain cases. Long term effects like neurological, arthritic or chronic symptons do not occur is STARI unlike Lymes disease

Treatment: Antibiotic treatment is recommended which involves broad spectrum antibiotics like Tetracyclines (Doxycycline). The immediate symptoms are mitigated with Doxycycline. Patients recover more fastly in STARI disease when compared to Lyme Disease.

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