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Three cases diagnosed not Lyme disease but "tick-associated rash illness (TARI)" in Japan

Yuki Moriyama1, Satoshi Kutsuna1, Yuta Toda1

  • 1Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.

Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy
|December 14, 2020
PubMed

Insights

Tick-associated rash illness (TARI) can cause erythema migrans (EM) after a tick bite in Japan. Physicians should be aware of TARI, as EM does not always indicate Lyme disease in this region.

Area of Science:

  • Medical Research
  • Infectious Diseases
  • Dermatology

Background:

  • Lyme disease is a tick-borne illness often characterized by erythema migrans (EM).
  • The distribution of Lyme disease vectors is limited in many regions of Japan.
  • Tick-associated rash illness (TARI) is an emerging concern.

Observation:

  • Three cases of TARI presenting with EM following a tick bite in Japan were observed.
  • Erythema migrans (EM) appeared in patients who were not infected with Lyme disease pathogens.
  • These cases highlight a potential diagnostic challenge in distinguishing TARI from Lyme disease.

Findings:

  • Erythema migrans (EM) can manifest in tick-bite patients without Lyme disease.
  • The absence of typical Lyme disease vectors in most of Japan suggests alternative causes for EM.
  • Tick-associated rash illness (TARI) is a distinct possibility in patients presenting with EM post-tick bite.

Implications:

  • Increased physician awareness of TARI in Japan is crucial for accurate diagnosis and treatment.
  • Misdiagnosis of Lyme disease can be avoided by considering TARI in endemic-free areas.
  • Further research into TARI and its causative agents in Japan is warranted.
Keywords:
AsiaErythema migransJapanTick biteTick-associate rash illness

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