Removal · field guidance

Distinguishing STARI from Lyme on serology

STARI patients typically have a negative Lyme two-tier despite an EM-like rash, helping separate it from true Lyme acquired from Ixodes ticks.

Steps

schema.org/HowTo

01
Confirm exposure: STARI follows lone star (Amblyomma americanum) bites in the southeastern US.
02
Run standard CDC two-tier Lyme serology — usually negative in STARI.
03
There is no validated lab test specific for STARI; diagnosis is clinical and exclusionary.
04
A negative Lyme test plus a southern-tier exposure favors STARI.
05
Clinical management often parallels early Lyme (doxycycline) although the causative agent is unproven.

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