Solitary Erythema Migrans in Georgia and South Carolina

Felz, Michael W.; Chandler, Francis W.; Oliver, James H.; Rahn, Daniel W.; Schriefer, Martin E.

doi:10.1001/archderm.135.11.1317

Cited by 65 publications

(47 citation statements)

References 51 publications

(43 reference statements)

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“…Cases consistent with this clinical presentation have been reported from several southeastern and south central states, including Missouri, Maryland, Georgia, South Carolina, and North Carolina (2,7,12,17,27,28). The majority of patients with STARI do not have laboratory evidence of infection with B. burgdorferi sensu stricto (7).…”

supporting

confidence: 57%

“…However, a Lyme disease-like illness that develops following the bite of the Lone Star tick, Amblyomma americanum, has been described (2,7,12,17,27,28). Individuals affected with this illness, termed "southern tick-associated rash illness" (STARI), commonly develop a localized expanding circular skin rash (erythema migrans) at the site of the tick bite similar to that seen with classic Lyme disease.…”

mentioning

confidence: 99%

“…Molecular evidence of B. lonestari has been reported in A. americanum from Alabama, New Jersey, Tennessee, and Texas, as well as in a patient who apparently acquired infection in either North Carolina or Maryland (4,6,14). Suspected cases of disease have also been reported from Missouri, Georgia, South Carolina, and Maryland, but molecular assays to ascertain the presence of B. lonestari in those patients were not performed (2,7,12,17,27,28). Our data confirm that B. lonestari or a very closely related Borrelia spp.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Detection of Borrelia lonestari , Putative Agent of Southern Tick-Associated Rash Illness, in White-Tailed Deer ( Odocoileus virginianus ) from the Southeastern United States

Moore¹,

Varela²,

Yabsley

et al. 2003

J Clin Microbiol

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supporting

confidence: 57%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Detection of Borrelia lonestari , Putative Agent of Southern Tick-Associated Rash Illness, in White-Tailed Deer ( Odocoileus virginianus ) from the Southeastern United States

Moore¹,

Varela²,

Yabsley

et al. 2003

J Clin Microbiol

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“…What is now termed STARI was first described in adolescents attending a summer camp in the North Carolina Piedmont [37]. As with several other studies on STARI, it is notable that some subjects had positive enzyme-linked immunosorbent assays and some positive bands on immunoblots for B. burgdorferi [32,[37][38][39]. Interestingly, the female subject in this report had a reactive IgM 23-kDa band following one episode of presumed STARI (illness 2).…”

Section: Discussionsupporting

confidence: 55%

Retrospective Case Reports of Two Central North Carolina Residents

Herman-Giddens

2017

North Carolina Medical Journal

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“…Since the mid-1980s, physicians have described a Lyme disease-like illness in patients from the southeastern and southcentral United States in which an erythema migrans rash and mild flu-like symptoms develop following the bite of a lone star tick, Amblyomma americanum (2,3,12,19,31,43). This disease is alternatively referred to as southern tick-associated rash illness (STARI), Master's disease, or southern Lyme disease (23,30).…”

mentioning

confidence: 99%

First Culture Isolation of Borrelia lonestari , Putative Agent of Southern Tick-Associated Rash Illness

Varela¹,

Luttrell

Howerth³

et al. 2004

J Clin Microbiol

107

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Southern tick-associated rash illness (STARI) is a Lyme disease-like infection described in patients in the southeastern and south-central United States, where classic Lyme disease is relatively rare. STARI develops following the bite of a lone star tick (Amblyomma americanum) and is thought to be caused by infection with an "uncultivable" spirochete tentatively named Borrelia lonestari. In this study, wild lone star ticks collected from an area where B. lonestari is endemic were cocultured in an established embryonic tick cell line (ISE6). The cultures were examined by dark-field microscopy for evidence of infection, and spirochete identity and morphology were evaluated by flagellin B and 16S rRNA gene sequence, by reaction to Borrelia-wide and B. burgdorferi-specific monoclonal antibodies, and by electron microscopy. Live spirochetes were first visualized in primary culture of A. americanum ticks by dark-field microscopy 14 days after the cell culture was inoculated. The sequences of the flagellin B and 16S rRNA genes of cultured spirochetes were consistent with previously reported sequences of B. lonestari. The cultured spirochetes reacted with a Borrelia-wide flagellin antibody, but did not react with an OspA antibody specific to B. burgdorferi, by indirect fluorescent antibody testing. Electron microscopy demonstrated organisms that were free and associated with ISE6 cells, with characteristic Borrelia sp. morphology. This study describes the first successful isolation of B. lonestari in culture, providing a much needed source of organisms for the development of diagnostic assays and forming a basis for future studies investigating the role of the organism as a human disease agent.

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Solitary Erythema Migrans in Georgia and South Carolina

Cited by 65 publications

References 51 publications

Detection of Borrelia lonestari , Putative Agent of Southern Tick-Associated Rash Illness, in White-Tailed Deer ( Odocoileus virginianus ) from the Southeastern United States

Detection of Borrelia lonestari , Putative Agent of Southern Tick-Associated Rash Illness, in White-Tailed Deer ( Odocoileus virginianus ) from the Southeastern United States

Retrospective Case Reports of Two Central North Carolina Residents

First Culture Isolation of Borrelia lonestari , Putative Agent of Southern Tick-Associated Rash Illness

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