“…Due to today's progressive standards for informed consent, such studies may be difficult or impossible to conduct since they would require a cohort of patients agreeing to no treatment over time in the face of existing evidence of Lyme-like symptoms associated with STARI [33]. Most reports support treating these patients as for Lyme disease [41][42][43], though some question whether treatment is needed in spite of the condition's Lyme-like symptoms [44]. A recent study suggests that in the South, some cases of Lyme disease-like illnesses may be attributable to lone star tick-vectored infections with previously undetected B. burgdorferi sensu lato [45], but more research is needed to confirm these findings.…”