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Southern Tick Associated Rash Illness or what the doctor didn't know.

Update 3-5-2013 - please see below

The Lone Star tick, common to the southeastern U.S.
I got bit Sunday February 17th during a volunteer workday out in the woods pulling invasive plants. This was in Chattahoochee, FL at the Angus Gholson Nature Park. After a pleasant lunch with the coordinator and her friend, during the drive home I felt something on my ankle and when I got home 30 minutes later it was intense. As bad as any bee sting but it felt more like something with teeth gnawing on my ankle. I couldn't wait to drop my socks and see. Yup, a tick, a teeny tiny tick. I quick pulled it off and dropped it in a saucer of water I'd left on my deck.

The next day I fished out that dead tick with a Q-tip and saved it just in case. Good thing because by Saturday a rash was starting - raw red in color and the size of a quarter. Didn't take long to search the web and find out what might be going on - STARI caused by a Lone Star tick. Monday I headed off to the doctor with the rash now a half dollar.

Photos of my bite and rash below (nothing too gross), the doctor's response, and more links to STARI and news of a possible related allergy.

The doctor - ah yes the doctor - asked all the usual questions: When did you get bit, how long was it attached, when did symptoms appear???  This is what she was looking at but doubled by Monday.

"Well," she said, "it's not Lyme's Disease since the tick was not attached long enough to transfer. They need to be on you 2-3 days."

"I know that but this is a Lone Star tick. Here, look at this. I saved it." Then I pulled out my vial with the tick stuck on the end of the Q-tip. She got her little magnifier and inspected it. The verdict was yes, it's a Lone Star tick in the nymph stage. And I get complimented for having the foresight to save the tick.

Again she said I did not have Lyme disease. And again I said I knew that, but how about STARI? "I do not know that," she answered.

"It's on the CDC website. Dub Dub Dubya dot C D C dot GOV slash S T A R I."

Time out as she opens up her laptop and goes to the site and starts reading. Then we go back and forth, "Whaddya think?"

"Thank you, I did not know this," she repeated. "I don't think you have STARI because the tick was attached long enough."

"But it doesn't say that..."

"Yes but I have seen lots of tick bites and removed many. The tick has to be on you longer."

And back and forth we went. I wish I had know about this site from the American Lyme Disease Foundation.  And reading later I found out about a possible relation between the Lone Star tick and a meat allergy. And surprise! If she had read the alert from the Florida Dept of Health, she would have know that the CDC was looking to do research on STARI and here are instructions. Sheesh - I had everything they need - the tick, the place (within a 1/4 mile), the time, the duration, the visible symptoms, photos ....

Anyways, cutting this short, the doctor insisted it was simply a local reaction and antibiotics (Doxycycline) were not needed. I'm all for not using those drugs so I let it go. I figured it would either get better on its own or not.

So, here's my tick bite and rash after 2 weeks.

I'll wait a couple more days but I do believe a second opinion is warranted.

Update 3-5-2013 - thank you all for your insights and concerns.
I saw a 2nd doctor this morning. Alas he also was unaware of STARI, had not read the CDC or FL DOH alerts, and was ready to pass it off as a skin-related staph infection. I insisted and he left and read up on it and then became more concerned. Came back 3 times, the last time with a magnifier for a close look, and ordered blood testing. I start (as soon as my late lunch gets digested) on 100 mg doxycycline twice a day for 21 days. He thinks I should see clearing in a week.

Originally posted to PHScott on Mon Mar 04, 2013 at 04:33 PM PST.

Also republished by Backyard Science and Lyme Disease Awareness.

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