Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2022; 10(19): 6695-6701
Published online Jul 6, 2022. doi: 10.12998/wjcc.v10.i19.6695
Ant sting-induced whole-body pustules in an inebriated male: A case report
Shi-Qi Chen, Tao Yang, Li-Fang Lan, Xiao-Ming Chen, Dong-Bei Huang, Zhao-Lin Zeng, Xiao-Ying Ye, Chun-Lei Wan, Long-Nian Li
Shi-Qi Chen, Tao Yang, Li-Fang Lan, Xiao-Ming Chen, Dong-Bei Huang, Zhao-Lin Zeng, Xiao-Ying Ye, Chun-Lei Wan, Long-Nian Li, Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
Author contributions: Wan CL, Li LN, Yang T, Lan LF and Huang DB investigated and collected the medical records of the patient; Li LN reviewed the literature; Li LN, Chen SQ and Yang T drafted the manuscript; Zeng ZL, Ye XY and Chen XM supervised the manuscript; All authors agreed to submit the final version.
Informed consent statement: Informed written consent was obtained from the patient and his families for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Long-Nian Li, MD, PhD, Chief Doctor, Department of Dermatology, First Affiliated Hospital of Gannan Medical University, No. 23 Qingnian Road, Zhanggong District, Ganzhou 341000, Jiangxi Province, China. li_longnian@foxmail.com
Received: January 16, 2022
Peer-review started: January 16, 2022
First decision: March 25, 2022
Revised: April 6, 2022
Accepted: May 12, 2022
Article in press: May 12, 2022
Published online: July 6, 2022
Processing time: 159 Days and 7.2 Hours
Abstract
BACKGROUND

Many ant species can harm humans; however, only a few cause life-threatening allergic reactions. Normally, reactions caused by ants occur in patients who come into contact with ant venom. Venom contains various biologically active peptides and protein components, of which acids and alkaloids tend to cause anaphylaxis. Ant venom can cause both immediate and delayed reactions. The main histopathological changes observed in ant hypersensitivity are eosinophil recruitment and Th2 cytokine production.

CASE SUMMARY

A 70-year-old man was bitten by a large number of ants when he was in a drunken stupor and was hospitalized at a local hospital. Five days later, because of severe symptoms, the patient was transferred to our hospital for treatment. Numerous pustules were observed interspersed throughout the body, with itching and pain reported. He had experienced fever, vomiting, hematochezia, mania, soliloquy, sleep disturbances, and elevated levels of myocardial enzymes since the onset of illness. The patient had a history of hypertension for more than 1 year, and his blood pressure was within the normal range after hypotensive drug treatment. He had no other relevant medical history. Based on the clinical history of an ant bite and its clinical manifestations, the patient was diagnosed with an ant venom allergy. The patient was treated with 60 mg methylprednisolone for 2 d, 40 mg methylprednisolone for 3 d, and 20 mg methylprednisolone for 2 d. Oral antihistamines and diazepam were administered for 12 d and 8 d, respectively. Cold compresses were used to treat the swelling during the process. After 12 d of treatment, most pustules became crusts, whereas some had faded away. No symptoms of pain, itching, or psychological disturbances were reported during the follow-up visits within 6 mo.

CONCLUSION

This case report emphasizes the dangers of ant stings.

Keywords: Ant sting; Sterile pustule; Psychological disturbances; Anaphylaxis; Ant venom allergy; Delayed reaction; Case report

Core Tip: Ant sting allergies tend to be overlooked because their symptoms are usually mild and common. Although cases of ant sting allergies have been reported worldwide, cases involving a large number of ant stings occurring in one patient are rarely reported. The effect of injecting a large amount of venom into an elderly individual and its allergenicity should not be underestimated. This case report highlights the importance of defending against the dangers of ant stings, and emphasizes that basic knowledge of ants, ant venom, and ant sting allergies should be enhanced.