Cutaneous allergic vasculitis due to Solenopsis geminata (Hymenoptera: Formicidae) envenomation in Indonesia.

Severe cutaneous allergic vasculitis in a 60 year-old Caucasian male following the bite of the tropical fire ant, Solenopsis geminata (F.) is reported. Over the course of 8 weeks, the pathology progressed from an extensive red papular urticaria to vasculitis with peri-vascular inflammation and ulceration of the skin on the feet, ankles and lower limbs. Many of the affected areas of the skin eventually became covered with black eschar associated with further tissue breakdown and ulcer formation. After debridement, compression dressings, antimicrobial ointment and corticosteroids, complete healing eventually took place with only residual scarring. An awareness of the severe dermatologic reactions caused by a bite of S. geminata, albeit rare, is clinically important. Recognizing the characteristic skin lesions caused by the bite of S. geminata, treated with prompt administration of appropriate chemotherapy will speed recuperation of the patient and reduce possible secondary complications.

Características clínicas das reações por venenos de Hymenoptera e valor diagnóstico da determinação de IgE sérica específica nas alergias provocadas por estes insetos / Clinical characteristics of Hymenoptera venom reactions and the value of specific serum IgE determination in the diagnosis of these insect allergies

A ordem Hymenoptera é constituída pelas abelhas, vespas e formigas. Alergias aos venenos desses insetos podem ocasionar reações graves, muitas vezes fatais. O Brasil possui poucos dados epidemiológicos sobre alergia aos himenópteros e há poucos estudos que avaliem as características da determinação de IgE sérica específica e o seu papel no diagnóstico da alergia a estes insetos. Este trabalho tem como objetivo estudar os pacientes com alergia a himenópteros, em relação a parâmetros clínicos e testar o valor diagnóstico do método utilizado para a determinação sérica de IgE específica, de acordo com os parâmetros de sensibilidade, especificidade, valores preditivo positivo e negativo./The Hymenoptera order is constituted by bees, wasps and ants. The insect venoms allergies could provoke severe reactions, many times fatal. Brazil has few epidemiologic data about Hymenoptera allergy and there are few studies about specific serum IgE determination characteristics and its role in these insect allergies diagnosis. The aims of the present study are to analyze the patients with Hymenoptera allergy history based on clinical parameters and analyze the diagnostic value of the method used in specific serum IgE determination considering sensitivity, specificity, positive and negative predictive values...

A case of anaphylaxis by ant (Ectomomyrmex spp.) venom and measurements of specific IgE and IgG subclasses

Hypersensitivity to the stings of the Hymenoptera has been described since antiquity. The hypersensitive reactions to insect stings vary from minor skin reactions to severe and sometimes fatal anaphylaxis. Concerns about sting hypersensitivity have been increasing because of many incidents of allergic reactions of patients to the fire ant in the southern area of the United States as well as the harvester ant in some areas. We experienced one unique case with severe allergic reactions by ant of the Ectomomyrmex spp. of the subfamily Ponerinae, which is not a harvester ant. For three years the patient had been suffering from generalized allergic reactions such as anaphylaxis after the ant stings four-five attacks in a year. We determined that her reactions were due to specific IgE mediated type I hypersensitivity by the detection of a high level of specific IgE to the ant venom in her serum. The high level of specific IgG4 to the ant venom was also noted in her serum, however, the role of ant venom IgG4 was not clearly determined.