A Case of Illness Following a Bite by a Male Lone Star Tick (<scp><i>Amblyomma americanum</i></scp> Linnaeus) Infected With <scp><i>Ehrlichia</i></scp> sp. and <scp><i>Rickettsia amblyommatis</i></scp> in Connecticut, United States

The lone star tick (<i>Amblyomma americanum</i> Linnaeus) is a species commonly found in the southeastern U.S., but in recent years its populations have expanded northward, resulting in an increased risk of tick-borne pathogen transmission in the Northeast. We report a case of local lymphadenopathy and a flu-like illness in a Connecticut man, following a bite by a male lone star tick infected with <i>Ehrlichia</i> sp. and <i>Rickettsia amblyommatis</i>. It has been documented that <i>Ehrlichia</i> sp. can cause such illness; however, we cannot entirely rule out the potential involvement of <i>R. amblyommatis</i> as a co-conspirator. Our finding highlights the importance of changing dynamics of pathogen activities and its clinical ramifications in a region with pervasive populations of the blacklegged tick (deer tick, <i>Ixodes scapularis</i> Say) and the recently established presence of at least three non-native species, including the lone star tick. The case described here with a localized reaction and flu-like symptoms following a bite by a male lone star tick and subsequent evidence of infection in the tick vector with two unique aforementioned pathogens signifies the need for early detection and treatment of these particular diseases, especially when they have specific or unusual symptoms. These efforts that can be achieved through extensive tick and tick-borne pathogen surveillance programs will help to reduce possible health hazards, guide diagnosis and treatment, and improve our understanding of the clinical consequences of related illnesses.