Diagnosis is based on a circular "bull's-eye" rash at the site of infection called erythema chronicum migrans, which is very similar to that seen in Lyme disease.

However, the symptoms of STARI are mild, and resemble influenza, with fatigue, muscle pains, and headache.

This illness is a tick-borne disease carried by the lone star tick Amblyomma americanum.

[4][1] Several studies have failed to detect Borrelia burgdorferi, which is the causative agent of Lyme disease, in patients from the southern United States.

[9] However, this conclusion is controversial since the spirochete is not detected in all cases of the syndrome,[6] which has led some authors to argue that the illness is not caused by a bacterial pathogen.