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You are watching: How many fire ant bites is dangerous

StatPearls . Treasure Island (FL): StatPearls Publishing; 2021 Jan-.


Continuing education Activity

Fire ants have tendency to be an wild insect that will certainly sting causing an extremely painful reactions. There room two types of fire ants which belong to the Solenopsis species. The first is a red, imported fire ant, Solenopsis invicta and also the 2nd is the black imported fire ant, Solenopsis richteri. This activity reviews the pathophysiology of fire ant bites and also highlights the role of the interprofessional team in the management.

Outline the prestige of improving treatment coordination among interprofessional team members to boost outcomes for patients influenced by fire ant bites.


Fire ants often tend to it is in an wild insect that will sting causing an extremely painful reactions.  There space two varieties of fire ants which belong come the Solenopsis species. The an initial is a red, imported fire ant, Solenopsis invicta and the 2nd is the black imported fire ant, Solenopsis richteri. They to be introduced into the United states at Mobile, Alabama about 40 year ago. Red fire ants are predominately watched in 14 states: Alabama, Arkansas, California, Florida, Georgia, Louisiana, Mississippi, new Mexico, north Carolina, Oklahoma, southern Carolina, Tennessee, Texas, and Virginia. An international locations include the Caribbean islands, Puerto Rico, the Bahamas, the British and United states Virgin Islands, Antigua, and also Trinidad, Australia, brand-new Zealand, Taiwan, and China.

The black color fire ant is seen only in north Alabama, north Mississippi, and southern Tennessee.

Over the following decade, the fire and Solenopsis invicta is meant to spread to California and also towards the Pacific shore nearing the Canadian border.

Fire ants perform not have to be provoked come attack, and also their venom is qualified of bring about a painful regional reaction and, in part instances, an outcome in life-threatening anaphylaxis. <1><2><3>


Ant bites usually happen when their swarm is disturbed. They will certainly swarm and also sting any living person or pet with which lock come in contact.  One ant is qualified of lot of stings within a very short time frame. Bites can occur year-round however are most common in the summer months.  <4><5><6>


Ant bites occur most commonly in children, typically on the lower extremities. Patients who are much less mobile are likewise at risk because they room less aware of their environment and often space not able to move away from the ants. Ants do not discriminate between age or sex and also will attack any living animal.<7>


When the ant stings, the does so with its mandible, i beg your pardon locks ~ above its prey. It arches that is body and also then injects venom through the stinger located on the abdomen. Together it stings, it does so at an median of 7-8 stings. That rotates its human body which outcomes in a one pattern bring about pain and itching at the site. The venom of the fire ants is provided to immobilize or death prey for food however has additionally demonstrated insecticidal, bactericidal, and fungicidal activity. The gift is 95% water-insoluble alkaloid, through the continuing to be 5% being an aqueous protein solution. The is the alkaloid part of the gift that reasons a sterile pustule at the sting site and also has cytotoxic and hemolytic properties. The protein part contains the allergens. The reactions range from immediate localized wheal and also flare responses to large, regional or systemic reaction which can encompass anaphylaxis. 

The immediate reaction to the venom is an extreme burning sensation which explains the typical name the the ants. Once the sensation subsides ~ a few minutes, a dermal flare and wheal occur and papules kind within 2 hours. Vesicles develop within four hours and by 24 hrs these construct into sterile pustules. A pustule forms as a an outcome of the gift alkaloids, however it is no allergenic.

Another an answer is the huge local reaction, i beg your pardon is characterized by a reaction bigger than 10 cm in diameter and associated v localized erythema and also edema. Lock are an extremely painful and also pruritic, lasting 24 come 72 hours. 

The local reactions the the fire ant sting can cause anaphylaxis, which is a solution to the aqueous protein solution. Anaphylaxis normally occurs in those sensitized through a vault sting. These symptoms encompass flushing, generalized urticaria, angioedema, laryngeal edema, bronchospasm, or lose of consciousness.

Fire ant stings additionally are qualified of causing serum sickness, nephrotic syndrome, seizures, worsening of pre-existing cardiopulmonary disease, and also anaphylaxis.


The local reactions are IgE-mediated, v the resulting lesion consisted of of a dense fibrin gel in addition to eosinophils, neutrophils, and lymphocytes. Cutaneous systemic allergic reactions include urticaria, angioedema, pruritus, and also erythema and severe, life-threatening bronchospasm or laryngeal edema. One sting can cause anaphylaxis. The identify hallmark of fire ant envenomation is the pustules that kind after the sting.

History and also Physical

The most common scenario is one where the patience is outside, in the yard or the woods, and is standing on or close to an ant nest. Disrupting the nest reasons a huge number that ants come swarm and also attack. However, the imported fire ant can strike with tiny warning. The ants will certainly swarm and repeatedly sting the reduced body. The most common reaction is a wheal and flare, i m sorry is a lesion that has actually resembles a hive but likewise is surrounded by erythema. The stings are very painful and cause extreme itching. A 2nd lesion the can an outcome is a sterile pustule that creates within the very first 24 hours and is filled through yellow fluid. They room sterile and are the an outcome of the venom alkaloids lasting for about one week. A large, neighborhood reaction, generally over 10cm in diameter, may take place which has actually a pustule on optimal of a pains inflamed and swollen area. Lastly, anaphylaxis is possible. However, these reactions frequently occur in those who have actually been stung by one ant or a yellow jacket once prior to as its venom is known to cross-react with the Solenopsis venom in vitro.


Diagnosis of ant-induced hypersensitivity can be carry out by a patient history of allergy reaction to stings, by physics examination, or with the usage of in vivo or in-vitro tests. Advantageous clinical hints to aid in the diagnosis that a fire ant bite incorporate the advance of a typical pustule at the sting site after 24 hours. Identification of the ant is valuable in the diagnosis. The most specific diagnosis comes from the clinical manifestations that fire ant sting reactions v IgE detection through skin testing.

Treatment / Management

Most ant bites need supportive care, so therapy is aimed at preventing secondary bacterial infections if a pustule is disrupted. The use of topical hydrocortisone or antihistamine cream is typically all that is needed. The sterile pustules have to be left alone, however, if they are broken then they should be cleaned with soap and water and also an antibiotic cream placed on top. If the broken lesion gets infected, then a ideal antimicrobial have the right to be used. Those with big local reactions will advantage from a solitary dose of 20 mg prednisone. Localized pain and also swelling might be enhanced with cold compresses. Anaphylactic reactions space treated the same as any other anaphylaxis, making use of epinephrine very first followed by steroids, antihistamine, and H2 blocker. Fluid resuscitation and oxygen therapy need to be had as part of donate treatments.<8><9>

Differential Diagnosis

One need to be conscious of various other potential insects that sting, such as a yellow jacket or bee. Most regional reactions have erythema, so distinguishing this from cellulitis is important. Patients that have had actually hypotension through stings need to be evaluated because that mast cabinet disorders and also have a baseline tryptase level ordered.


The prognosis is very good for patient presenting v ant bites as many bites are regulated conservatively no requiring considerable care. Patients who seek medical care demonstrate major systemic allergy reactions which occur in about 2% the fire ant stings. One research reported 83 deaths out of 29,300 patients. Infants and also the elderly were the many at risk.

Pearls and also Other Issues

First Aid

Rub off ants briskly, as they room able to connect to your skin and also sting many times. Antihistamines and corticosteroid creams might help. If you develop severe chest pain, nausea, sweating, shortness that breath, major swelling or slurred speech, seek prompt medical attention.  


Do no disturb ant mounds. Be careful when lifting any items off the ground together ants may be underneath. Tuck pants right into socks or boots. A person through a known, major allergy come insect bites or stings should carry an epinephrine auto-injector and also wear clinical identification jewel listing the allergy.

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Enhancing health care Team Outcomes

Fire ant bites room not uncommon in souther USA. Because most patients existing to the emergency room complying with a fire ant bite, the triage nurse must understand the signs and also symptoms of the disorder. Because the fire ant bite deserve to be connected with a serious allergic response, timely admission and treatment is mandatory. For the most part, the bite the a fire ant is regulated with supportive care, yet sometimes one may need to an antihistamine and an NSAID come decrease the itching and also pain. Personnel in the emergency room must be familiar with the usage of epinephrine in case a patient has actually an anaphylactic shock.  A person with a known, severe allergy to insect bites or stings should carry an epinephrine auto-injector and wear medical identification jewel listing the allergy.