Woman has multiple lone star tick bites after walk in park

A young woman presented to the emergency department with multiple tick bites and erythematous papules, along with headaches, fatigue and arthralgias. She had been walking her dog in the woods in a state park in the metropolitan area of Washington, D.C.

She later found multiple ticks on her bedsheet and 30 ticks on her back, many of which had white spots on their backs.

“The most distinguishing feature of this patient’s ticks is the white spot on its back, which points to the [lone star tick] LST as the actual culprit,” the authors state.

The woman also “had red papules 2 to 3 mm in diameter all over her body, particularly on her back, hands, and feet. A rash around her navel appeared 3 days later,” the authors state.

“While the LST is not typically thought to be present in the Northeast, the presence of the white spot on the patient’s ticks helped identify it as the LST,” the authors state.

After she was treated with antibiotics, her symptoms resolved completely.

Click here to view tick photos.

Various tick-borne diseases can cause similar symptoms including fever, muscle aches, fatigue, headaches, and rashes.

In this case, the woman appeared to be bitten by the lone star tick, which is characterized by a white spot on its back.

The lone star tick can transmit several bacterial and viral infections, as well as red meat allergy. The following diseases are associated with this tick species:

• Ehrlichiosis
• Tularemia
• Southern tick-associated rash illness
• Bourbon virus
• Heartland virus
• Alpha-gal syndrome (red meat allergy)

“Despite being a common tick species with a large range extending over half of the eastern United States, the LST is not as well-known everywhere in its range,” the authors point out.

Furthermore, “The LST is clearly an important tick species for pediatricians to keep in mind as they care for children who live and/or travel in the eastern United States.”