Other studies have shown that some patients presenting with EM in the southern United States, though given a diagnosis of STARI, will actually test positive for Borrelia.
Further research into the prevalence of Borrelia in Louisiana, as well as the causative organisms, laboratory testing, and proper treatment of STARI, is warranted.
IgM IgG 18 kDa 21 kDa (OspC) 24 kDa (OspC) 28 kDa 30 kDa 39 kDa (BmpA) 39 kDa (BmpA) 41 kDa Fla 41 kDa (Fla) 45 kDa 58 kDa (not GroEL) 66 kDa 93 kDa Table 2: Characteristics of Lyme and STARI Disease Most Common Geographic EM Borrelia Long-Term Distribution in US Rash Serology Sequelae Lyme Northeast and North Central + + + or - STARI Southeast + - -
In a prospective clinical evaluation of EM, lesions in STARI patients from Missouri were substantially smaller and more likely to have central clearing, and patients had a lower mean symptom score, compared with LD patients in a New York study (3).
ticks are the vector, STARI is thought to be spread by the Lone Star tick (Ambylomma americanum), the most common tick parasitizing humans in the southeastern and south-central United States (4).
First recognized in 1998, STARI manifests initially as erythema migrans as in LD, but occurs in regions of the Gulf South where B.
Herman-Giddens, there have been several additional clinical, epidemiological, microbiological, and molecular genetic investigations on the causative agent of STARI all of which support the conclusions that Borrelia burgdorferi is not the causative agent of STARI and that B.
more accurate diagnoses of Lyme disease or STARI
in the state.
americanum males collected near the homes of controls and 1 of 5 adult females collected near the homes of STARI
controls was positive.