 |
|
Physician-Diagnosed Erythema Migrans and Erythema Migrans–like Rashes Following Lone Star Tick Bites
Edwin Masters, MD;
Scott Granter, MD;
Paul Duray, MD;
Paul Cordes, MD
Arch Dermatol. 1998;134:955-960.
Objective To differentiate cases of physician-diagnosed erythema migrans and erythema migrans–like rashes associated with Lone Star tick (Amblyomma americanum) bites.
Design Retrospective case series.
Setting Private primary care clinic in rural Missouri.
Patients Seventeen patients with physician-diagnosed erythema migrans following a definite Lone Star tick bite at the rash site.
Interventions A biopsy was performed on all rash sites. All patients were treated with oral antibiotics.
Main Outcome Measures Rash appearance, size, body location, multiple lesions, incubation time, associated symptoms, seasonal occurrence, histopathological features, tick stage and sex, patient age and sex, treatment response, growth in BSK II culture media, and serologic evaluation.
Results Rashes associated with Lone Star ticks were similar to erythema migrans vectored by other Ixodes ticks. Differences were noted in Lyme disease serology results, especially flagellin-based enzyme immunoassays, and failure to yield spirochetes in BSK II cultures. Lyme serology results were often negative, but were also frequently inconsistent with results of controls without Lyme disease.
Conclusions Lone Star ticks are associated with rashes that are similar, if not identical, to erythema migrans associated with borrelial infection. The recent isolation and cultivation of Borrelia burgdorferi from ticks (including 1 Lone Star tick) from the farm of a patient included in this report has raised the possibility that Lone Star ticks are "bridge vectors" for human borrelial infection. Although further investigation is needed, these rashes may be secondary to spirochetal infection.
From Regional Primary Care, Cape Girardeau, Mo (Dr Masters); Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (Dr Granter); National Institutes of Health, Bethesda, Md (Dr Duray); and Southeast Missouri Hospital, Cape Girardeau (Dr Cordes).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Does This Patient Have Erythema Migrans?
Tibbles and Edlow
JAMA 2007;297:2617-2627.
ABSTRACT
| FULL TEXT
Highly Prevalent Coxiella sp. Bacterium in the Tick Vector Amblyomma americanum
Jasinskas et al.
Appl. Environ. Microbiol. 2007;73:334-336.
ABSTRACT
| FULL TEXT
Serologic Evaluation of Patients from Missouri with Erythema Migrans-Like Skin Lesions with the C6 Lyme Test
Philipp et al.
CVI 2006;13:1170-1171.
ABSTRACT
| FULL TEXT
Glycerophosphodiester Phosphodiesterase Gene (glpQ) of Borrelia lonestari Identified as a Target for Differentiating Borrelia Species Associated with Hard Ticks (Acari:Ixodidae)
Bacon et al.
J. Clin. Microbiol. 2004;42:2326-2328.
ABSTRACT
| FULL TEXT
First Culture Isolation of Borrelia lonestari, Putative Agent of Southern Tick-Associated Rash Illness
Varela et al.
J. Clin. Microbiol. 2004;42:1163-1169.
ABSTRACT
| FULL TEXT
Rocky Mountain Spotted Fever: A Clinician's Dilemma
Masters et al.
Arch Intern Med 2003;163:769-774.
ABSTRACT
| FULL TEXT
Detection of Borrelia lonestari, Putative Agent of Southern Tick-Associated Rash Illness, in White-Tailed Deer (Odocoileus virginianus) from the Southeastern United States
Moore IV et al.
J. Clin. Microbiol. 2003;41:424-427.
ABSTRACT
| FULL TEXT
Microbiologically Confirmed Early Lyme Disease
Masters
ANN INTERN MED 2002;137:698-698.
FULL TEXT
Resident burnout.
Smith and Steere
ANN INTERN MED 2002;137:698-700.
FULL TEXT
Solitary Erythema Migrans in Georgia and South Carolina
Felz et al.
Arch Dermatol 1999;135:1317-1326.
ABSTRACT
| FULL TEXT
Language, Logic, and Lyme Disease
Melski
Arch Dermatol 1999;135:1398-1400.
FULL TEXT
Erythema Migrans in the South
Masters et al.
Arch Intern Med 1998;158:2162-2165.
FULL TEXT
|
