Stinging ant anaphylaxis: Advances in diagnosis and treatment.

Stinging ants represent a wide range of over 200 different species across the world, of which Solenopsis, Myrmecia, Pogonomyrmex, and Brachyponera genera, account for a substantial economic and healthcare burden. S. invicta (red imported fire ant; IFA) and M. pilosula (jack jumper ant; JJA) are 2 species of high clinical importance, known to cause anaphylaxis in humans, with numerous reported fatalities. Diagnostic testing should be performed in patients with a history of a systemic reaction with skin testing and/or in vitro specific-IgE testing. In vitro testing is commercially available for IFA through whole-body extract (WBE) specific-IgE and JJA venom specific-IgE, but not widely available for other stinging ant species. Commercial venom component testing for IFA and JJA is currently not available. Patients with a clinical history and positive specific-IgE testing, should undergo treatment with specific immunotherapy, which is currently available for IFA and JJA. Build-up may be performed using conventional, semi-rush, rush, or ultra-rush schedules with similar risk profiles for IFA. Optimal duration for WBE immunotherapy for IFA and specific JJA venom immunotherapy is not well-studied, but generally recommended for at least 3-5 years. Sting challenges are used in research settings, primarily to assess treatment efficacy of immunotherapy.

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.