As the weather begins to warm up this spring, people in the Southern United States will begin to see small mounds of dirt ranging from 1-2 feet in diameter and less than a foot in height. Be careful, as this might be a fire ant mound. These ants are very aggressive and can sting a person multiple times almost immediately upon being disturbed.

The feet and ankles are main places on a person’s body where fire ants usually sting, but stings can certainly occur on other parts of the body. Typically, the victim of a fire ant sting will develop localized reaction/swelling, along with eventual development of a small pustule/blister at the site of the sting. There is no need to pop the small blister. For treatment of this, many patients will apply an over-the-counter topical steroid, such as hydrocortisone, and use an over-the-counter oral antihistamine to help with itching. If the localized reaction does not get better within a few days, and especially if there is any concern for infection, the patient should seek medical care.

For patients who develop symptoms beyond just localized swelling such as hives on multiple areas of the body, swelling away from the site of the sting (including the throat), vomiting, diarrhea, difficulty breathing, low blood pressure, and/or passing out, they should call 911 and seek immediate emergency medical care. Patients who have had severe allergic reactions to fire ant sting are typically prescribed an epinephrine auto-injector in case of future severe allergic reactions.

Board-certified allergists at Allergy Partners are trained in the recognition, management/treatment, and testing involved in fire ant allergy. After taking a detailed history and performing a physical exam, the allergist will decide on the need for testing to fire ants, which may include a skin test and/or blood test. Patients with severe allergic reaction history to fire ant and a positive test to fire ant are typically candidates for allergy shots (immunotherapy) to fire ant. Initially, at least once weekly shots occur at a medical office, & patients are asked to wait 30 minutes after an injection. Once patients reach the top dosing of the injections, the injections for fire ant allergy are often spaced to at least once monthly. Most patients at the top dosing of the shots will tolerate fire ant stings better and be at decreased risk for severe allergic reaction in the future.

We recommend that patients, adults and children, learn to recognize a fire ant mound if they live in a part of the country where fire ants predominate. Never provoke a fire ant mound, and wear closed-toe shoes and socks when outside. Patients prescribed an epinephrine auto-injector for fire ant allergy should always carry it with them in case of accidental sting. Those who have had severe reactions should contact their trusted Allergy Partners physician for evaluation and consideration of fire ant immunotherapy.


By Dr. Freccia

Allergy Partners of Fayetteville