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  1. Hymenopterans (Bees, Wasps and Ants)
  2. Biomedical Database
  3. Clinical entry: Formicidae (Ants)

Clinic: Formicidae (Ants)

Allergic reactions to ant venom

Single stings in non-sensitised individuals are uncomplicated, accompanied by pain, redness and swelling.

The main life-threatening risk stems from hypersensitation to ant venom.

Epidemiology, prevention and treatment see

  • Cardona V, Ansotegui IJ, Ebisawa M, El-Gamal Y, Fernandez Rivas M, Fineman S, Geller M, Gonzalez-Estrada A, Greenberger PA, Sanchez Borges M, Senna G, Sheikh A, Tanno LK, Thong BY, Turner PJ, Worm M. World allergy organization anaphylaxis guidance 2020. World Allergy Organ J. 2020 Oct 30;13(10):100472. PMID: 33204386; PMCID: PMC7607509. https://doi.org/10.1016/j.waojou.2020.100472
  • Sturm GJ, Schadelbauer E, Marta G, Bonadonna P, Kosnik M. Risk Factors for Severe Sting Reactions and Side Effects During Venom Immunotherapy. J Allergy Clin Immunol Pract. 2025 Jan;13(1):17-23.Epub 2024 Aug 20. PMID: 39173970. https://doi.org/10.1016/j.jaip.2024.08.025
  • Stoevesandt J, Sturm GJ, Bonadonna P, Oude Elberink JNG, Trautmann A. Risk factors and indicators of severe systemic insect sting reactions. Allergy. 2020 Mar;75(3):535-545. Epub 2019 Jul 16. PMID: 31194889. https://doi.org/10.1111/all.13945

Toxic effects of ant venom

Examine for venom effects

Autopharmacological effects

  • Nausea, vomiting
  • Sweating
  • Urticaria, angiooedema
  • Arterial hypotension / hypovolaemic shock
  • Diarrhoea
  • Bronchospasm 

Local Effects

  • Pain
  • oedema, extended swelling
  • Pustules

Haematological effects 

  • Bleeding
  • Haemolysis
    leading to
    • Arterial hypotension
    • Pale sclera
    • Oliguria, anuria (arterial hypotension / AKI)

Neurological effects

  • Various neurological signs & symptoms

Muscular effects

  • Generalized rhabdomyolysis:
    • Muscles pain and tenderness, painful on passive stretching, muscle stiffness, trismus
    • Bulbar and respiratory muscle weakness.
    • Dark brown urine. 
    • Renal failure
    • Laboratory: Generalized rhabdomyolysis: defined by a serum creatine kinase level > 10,000 U/l
    • ECG: Signs of hyperkalaemia.

Renal effects

  • Acute kidney injury:
    • Loin pain (lower back pain)
    • Renal bed sensitive to percussion
    • Haematuria, haemoglobinuria, myoglobinuria
    • Oliguria (< 400 ml of urine / 24 h), anuria
    • Uraemia (nausea, acidotic breathing, hiccups, pleuritic chest pain, encephalopathy) 

Clinical management

See also Clinical Management: hymenopterans

for advice on diagnosis (clinical, laboratory) and treatment (supportive).

Local treatment

Pain control
Tetanus prophylaxis
Standard wound care
Systemic antibiotics: standard indications
WHO (2010) 

Systemic supportive treatment

A general understanding of emergency medicine is required, or can be found in emergency medicine guidelines, e.g. ABCDE approach, WHO-ICRC Basic Emergency Care.

allergic and Toxic effects of Ant venom

Allergic reactions

Specific treatment (antivenoms)

No antivenoms available.

Reviews

USA

Solenopsis sp. (chiefly S. invicta)

  • DeShazo et al. (1990)
  • Stablein and Lockey (1987)

Australia

Myrmecia sp.

  • Sutherland and Tibballs (2001)

References

  • Cardona V, Ansotegui IJ, Ebisawa M, El-Gamal Y, Fernandez Rivas M, Fineman S, Geller M, Gonzalez-Estrada A, Greenberger PA, Sanchez Borges M, Senna G, Sheikh A, Tanno LK, Thong BY, Turner PJ, Worm M. World allergy organization anaphylaxis guidance 2020. World Allergy Organ J. 2020 Oct 30;13(10):100472. PMID: 33204386; PMCID: PMC7607509. https://doi.org/10.1016/j.waojou.2020.100472
  • DeShazo, R. D., B. T. Butcher, W. A. Banks (1990) Reactions to the stings of imported fire ant. New Engl. J. Med. 323: 462-466
  • Koya S, Crenshaw D, Agarwal A. Rhabdomyolysis and acute renal failure after fire ant bites. J Gen Intern Med. 2007 Jan;22(1):145-7.  PMID: 17351856; PMCID: PMC1824724. https://doi.org/10.1007/s11606-006-0025-z
  • Stablein, J. J., R. F. Lockey, A. E. Hensel (1985) Death from imported fire ant sting. Immunol. Allergy Pract. 7: 279-282
  • Stoevesandt J, Sturm GJ, Bonadonna P, Oude Elberink JNG, Trautmann A. Risk factors and indicators of severe systemic insect sting reactions. Allergy. 2020 Mar;75(3):535-545. Epub 2019 Jul 16. PMID: 31194889. https://doi.org/10.1111/all.13945
  • Sutherland SK, Tibballs J. Australian Animal Toxins. The Creatures, their Toxins and Care of the Poisoned Patient. 2nd ed. Melbourne: Oxford University Press; 2001.
  • WHO ABCDE Approach. https://cdn.who.int/media/docs/default-source/integrated-health-services-(ihs)/csy/bec-quick-cards/becp-edu29-pdf-en-finl.pdf?sfvrsn=2532d61b_2
  • WHO-ICRC Basic Emergency Care: approach to the acutely ill and injured. https://www.who.int/publications-detail-redirect/basic-emergency-care-approach-to-the-acutely-ill-and-injured. https://cdn.who.int/media/docs/default-source/integrated-health-services-(ihs)/csy/bec-quick-cards/becp-edu29-pdf-en-finl.pdf?sfvrsn=2532d61b_2
  • WHO (2010) Wound and lymphoedema management. WHO/HTM/NTD/GBUI/20101 I. 2010. https://www.who.int/publications/i/item/9789241599139