Southern Tick-Associated Rash Illness


The lone star tick, Amblyomma americanum, may cause Lyme disease-like rashes on patients. Rarely testing positive for Lyme disease, this infection is called Southern tick-associated rash illness (STARI). The etiology of STARI is still unknown.

Signs and Symptoms

The rash associated with STARI is a circular or elliptical red rash that typically appears within seven days of the tick bite. Symptoms include fever, headache, stiff neck, and mild muscle or joint pain. Long-term follow-up studies are necessary to understand the full scope of Southern tick-associated rash illness.


No serologic tests exist for STARI seeing as the etiololgical agent is unkown. Therefore, diagnosis is based on the typical rash appearance. STARI lesions are generally smaller, less variable in shape, and have more central clearing.