Expert Advice -- Bites: Fire ants

My two-year-old son stepped into an ant pile with no shoes on. His feet are covered in bites that have all blistered or come to a head. I have been treating him with Benadryl and topical hydrocortisone, but is there anything else I can do? I am not putting shoes on his feet, but how long will they stay swollen? I was told that the venom from the ants can cause problems for him if he is not treated, but my pediatrician didn't say anything about it.

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Robert Steele

Robert W. Steele, MD, is a board certified pediatrician at St. John's Regional Health Center in Springfield, MO. He graduated from medical... Read more

Early in the last century, some fire ants hopped aboard a ship in South America, which was destined for the United States. That ship docked in Alabama where these ants found their way onto land and have been multiplying and migrating ever since. Fire ants can now be found all over the South. It is estimated that up to 40 percent of all people living in urban areas infested with these insects will be stung each year. This is understandable when one realizes how these aggressive pests sting. First, the fire ant attaches to the unfortunate individual with its powerful jaws. Then, it repeatedly uses its stinger to inject venom into the skin.

The effects the venom can range from simple local reactions to life- threatening allergic reactions. Most people experience pain and swelling at the sting site. The swelling may evolve into small fluid filled pustules that itch. It is the swelling and tiny blisters, which usually require treatment due to the intense itching, pain, and swelling that may be associated with them. Less commonly, the stings provoke a larger reaction. This is particularly true when the arms or legs are stung. Swelling can effect the entire extremity, which is quite uncomfortable. Finally, an even more serious reaction involves an allergic response to the proteins in the venom. People who develop this experience hives, nausea, vomiting, and difficulty breathing.

The treatment for the common local reactions involves trying to decrease the symptoms. This is most often done using hydrocortisone cream and diphenhydramine (Benadryl) to help decrease the itching. There is no medication to counteract the venom. In addition, when the blisters break (usually from scratching) the lesions usually do not become infected. However, if one does become increasingly red, evaluation by a health-care provider is needed. If any signs of an allergic reaction occur, the most important thing to do is reach a medical facility as soon as possible.

I am very sorry to hear of your son's encounter with these troublesome ants. Your treatment is a typical one for local reactions to fire ant stings. The local effects of the venom cause discomfort but do not typically cause any long-term problems. The swelling of the feet usually only lasts 1 to 3 days, but the blisters can sometimes take up to 2 weeks to completely heal.

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