Diagnostic Considerations

Local reaction (infection, punctures, foreign bodies, various other dermatoses)

Toxic reaction (chemical exposure/ingestion, intravenous drug abuse, environmental, plants)

Allergic reaction (medications, illicit drugs, foods, topical products, environmental, plants, chemicals)

Differential Diagnoses

Workup

Kruse B, Anderson J, Simon LV. Fire Ant Bites. StatPearls [Internet]. 2019 Jan. [QxMD MEDLINE Link]. [Full Text].
Kemp SF, deShazo RD, Moffitt JE, Williams DF, Buhner WA. Expanding habitat of the imported fire ant (Solenopsis invicta): a public health concern. J Allergy Clin Immunol. 2000 Apr. 105(4):683-91. [QxMD MEDLINE Link].
Hoffman DR. Ant venoms. Curr Opin Allergy Clin Immunol. 2010 Aug. 10(4):342-6. [QxMD MEDLINE Link].
Potiwat R, Sitcharungsi R. Ant allergens and hypersensitivity reactions in response to ant stings. Asian Pac J Allergy Immunol. 2015 Dec. 33 (4):267-75. [QxMD MEDLINE Link].
Tankersley MS, Ledford DK. Stinging insect allergy: state of the art 2015. J Allergy Clin Immunol Pract. 2015 May-Jun. 3 (3):315-22; quiz 323. [QxMD MEDLINE Link].
Srisong H, Daduang S, Lopata AL. Current advances in ant venom proteins causing hypersensitivity reactions in the Asia-Pacific region. Mol Immunol. 2016 Jan. 69:24-32. [QxMD MEDLINE Link].
Haddad Junior V, Larsson CE. Anaphylaxis caused by stings from the Solenopsis invicta, lava-pés ant or red imported fire ant. An Bras Dermatol. 2015 May-Jun. 90 (3 Suppl 1):22-5. [QxMD MEDLINE Link].
More DR, Kohlmeier RE, Hoffman DR. Fatal anaphylaxis to indoor native fire ant stings in an infant. Am J Forensic Med Pathol. 2008 Mar. 29(1):62-3. [QxMD MEDLINE Link].
Smith KE, Fenske NA. Cutaneous manifestations of alcohol abuse. J Am Acad Dermatol. 2000 Jul. 43(1 Pt 1):1-16; quiz 16-8. [QxMD MEDLINE Link].
United States Department of Agriculture. Imported Fire Ants. Animal and Plant Health Inspection Service. Available at https://www.aphis.usda.gov/aphis/ourfocus/planthealth/plant-pest-and-disease-programs/pests-and-diseases/imported-fire-ants/ct_imported_fire_ants. November 8, 2019; Accessed: December 27, 2019.
Lee YC, Wang JS, Shiang JC, Tsai MK, Deng KT, Chang MY. Haemolytic uremic syndrome following fire ant bites. BMC Nephrol. 2014. 15:5. [QxMD MEDLINE Link].
Ford JL, Dolen WK, Feger TA, Hoffman DR, Stafford CT. Evaluation of an in vitro assay for fire ant venom-specific IgE. J Allergy Clin Immunol. 1997 Sep. 100(3):425-7. [QxMD MEDLINE Link].
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deShazo RD. My journey to the ants. Trans Am Clin Climatol Assoc. 2009. 120:85-95. [QxMD MEDLINE Link]. [Full Text].
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Media Gallery

Imported fire ant national distribution map. From http://fireant.tamu.edu. Reproduced with permission from B.M. Drees, Texas Imported Fire Ant Project Coordinator, Texas A&M University, College Station, Texas.
Red imported fire ant worker. From http://fireant.tamu.edu. Reproduced with permission from B.M. Drees, Texas Imported Fire Ant Project Coordinator, Texas A&M University, College Station, Texas.
Fire ant mound in lawn. From http://fireant.tamu.edu. Reproduced with permission from B.M. Drees, Texas Imported Fire Ant Project Coordinator, Texas A&M University, College Station, Texas.
Venom sac and stinger of a fire ant. From http://fireant.tamu.edu. Reproduced with permission from B.M. Drees, Texas Imported Fire Ant Project Coordinator, Texas A&M University, College Station, Texas.
Fire ant worker biting and stinging. From http://fireant.tamu.edu. Reproduced with permission from B.M. Drees, Texas Imported Fire Ant Project Coordinator, Texas A&M University, College Station, Texas.
Pustules and blisters formed following fire ant stings on the arm. From http://fireant.tamu.edu. Reproduced with permission from B.M. Drees, Texas Imported Fire Ant Project Coordinator, Texas A&M University, College Station, Texas.
Pustules and blisters formed following fire ant stings on the hand. From http://fireant.tamu.edu. Reproduced with permission from B.M. Drees, Texas Imported Fire Ant Project Coordinator, Texas A&M University, College Station, Texas.
Fire ant bites on the foot.

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Author

James P Ralston, MD President, Dermatology Center of McKinney

James P Ralston, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, Texas Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Ronald P Rapini, MD Professor and Chair, Department of Dermatology, The University of Texas MD Anderson Cancer Center; Distinguished Chernosky Professor and Chair of Dermatology, Professor of Pathology, University of Texas McGovern Medical School at Houston

Ronald P Rapini, MD is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, American Society of Dermatopathology, Association of Professors of Dermatology, Society for Investigative Dermatology, Texas Dermatological Society

Disclosure: Book royalties from Elsevier publishers.

Specialty Editor Board

Michael J Wells, MD, FAAD Dermatologic/Mohs Surgeon, The Surgery Center at Plano Dermatology

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey J Miller, MD Associate Professor of Dermatology, Pennsylvania State University College of Medicine; Staff Dermatologist, Pennsylvania State Milton S Hershey Medical Center

Jeffrey J Miller, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Society for Investigative Dermatology, Association of Professors of Dermatology, North American Hair Research Society

Disclosure: Nothing to disclose.

Chief Editor

Joe Alcock, MD, MS Associate Professor, Department of Emergency Medicine, University of New Mexico Health Sciences Center

Joe Alcock, MD, MS is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Additional Contributors

Daniel J Hogan, MD Clinical Professor of Internal Medicine (Dermatology), Nova Southeastern University College of Osteopathic Medicine; Investigator, Hill Top Research, Florida Research Center

Daniel J Hogan, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Contact Dermatitis Society, Canadian Dermatology Association

Disclosure: Nothing to disclose.