Epidemiology and Risk:
In 2001, a patient with evidence of B. lonestari infection was reported in the medical literature. This patient had exposure to ticks in Maryland and North Carolina, and developed a rash indistinguishable from erythema migrans after an A. americanum tick bite. DNA analysis indicated the presence of B. lonestari in a skin biopsy taken at the leading edge of the rash, and in the tick removed by the physician. Serologic testing for Lyme disease was negative. The patient was treated with an oral antibiotic and returned to normal health.
Lone star ticks can be found from central Texas and Oklahoma eastward across the southern states, and along the Atlantic coast as far north as Maine. Research indicates that live spirochetes are observed in only 1-3% of specimens. Note the anal orifice located in the center of the ventral abdominal surface.