Department of Medicine, College of Medicine, University of Arizona, Tucson.
Smithsonian Institution, Washington, DC.
Am J Med. 2019 Oct;132(10):1239-1241. doi: 10.1016/j.amjmed.2019.02.053. Epub 2019 Apr 3.
A middle-aged woman was taken from an abandoned automobile unconscious and covered with ants in Tucson, Arizona. When hospitalized in July 2018, she had an extensive papular-pustular skin eruption on her abdomen and thigh and disseminated intravascular coagulation. She was stung innumerable times by native golden fire ants (Solenopsis aurea) while sleeping in the vehicle. The large amount of venom injected by stings into this individual may have triggered dissemnated intravascualar coagulation because the venom contains powerful hemolytic factors.
The patient history is presented and ants were captured and identified.
Clinical findings of fire ant stings are presented and the importance of recognizing the distinctive skin lesions that occur is emphasized. Stings of the red imported fire ant, Solenopsis invicta, and the black imported fire ant, Solenopsis richteri, cause skin lesions recognized by physicians and victims alike in the southern and southeastern United States. Native fire ant stings are documented much less often. However, there is significant cross-reactivity among the venoms of Solenopsis species.
It is important for clinicians to recognize the characteristic skin lesions of fire ant envenomation as fire ant populations are expanding and they sting millions of people each year.
亚利桑那州图森市,一名中年女子被发现躺在一辆废弃汽车中,不省人事,身上满是蚂蚁。该女子于 2018 年 7 月住院时,腹部和大腿上出现广泛的丘疹脓疱性皮疹,并伴有弥散性血管内凝血。她在车内睡觉时被大量本地金红火蚁(Solenopsis aurea)叮咬。大量毒液通过叮咬进入体内,可能引发弥散性血管内凝血,因为毒液中含有强大的溶血性因子。
介绍了患者的病史,并对蚂蚁进行了捕获和鉴定。
呈现了红火蚁叮咬的临床发现,并强调了识别独特皮肤损伤的重要性。在美国南部和东南部,红入侵红火蚁(Solenopsis invicta)和黑入侵红火蚁(Solenopsis richteri)的叮咬会导致医生和患者都能识别的皮肤损伤。本地红火蚁叮咬的记录要少得多。然而,红火蚁属物种的毒液之间存在显著的交叉反应性。
由于红火蚁种群不断扩大,每年都会有数百万人被其叮咬,因此临床医生识别红火蚁螫伤的特征性皮肤损伤非常重要。