Fire Ant Bites Workup

Updated: Oct 04, 2016
  • Author: James P Ralston, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Workup

Laboratory Studies

Laboratory studies are not necessary for most people with fire ant stings; however, in severe reactions, a CBC count, coagulation studies, and a urinalysis could be obtained for the following uncommon but possible manifestations:

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Other Tests

Skin testing, enzyme-linked immunosorbent assay (ELISA), and radioallergosorbent testing (RAST) can be used to confirm a clinical history of fire ant hypersensitivity.

A venom ELISA assay has demonstrated equivalent sensitivity to venom RAST and is less expensive. [10] Reagents containing venom proteins are required for these tests. Because pure venom vaccines are not commercially available, whole-body extracts are used.

Patients without a clinical history of allergic reactions to fire ants should not be tested because of the high degree of asymptomatic IgE production in an exposed population.

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Histologic Findings

The histologic findings depend on the stage of evolution of the lesion. In early lesions, a perivascular infiltrate of lymphocytes, neutrophils, and eosinophils is found within the dermis. Later, an intraepidermal vesicle or pustule (containing mostly neutrophils) is usually present, often with a central focus of epidermal necrosis. Dermal edema is often present. Compared with other arthropod assaults, fire ant stings are far more pustular, with more neutrophils and fewer eosinophils.

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