Unconscious Woman in Shock and Covered with Ants Pulled from an Abandoned Automobile.

Background: A middle-aged woman was taken from an abandoned automobile unconscious and covered with ants in Tucson, Arizona. When hospitalized in July 2018, she had an extensive papular-pustular skin eruption on her abdomen and thigh and disseminated intravascular coagulation. She was stung innumerable times by native golden fire ants (Solenopsis aurea) while sleeping in the vehicle. The large amount of venom injected by stings into this individual may have triggered dissemnated intravascualar coagulation because the venom contains powerful hemolytic factors.

Methods: The patient history is presented and ants were captured and identified.

Results: Clinical findings of fire ant stings are presented and the importance of recognizing the distinctive skin lesions that occur is emphasized. Stings of the red imported fire ant, Solenopsis invicta, and the black imported fire ant, Solenopsis richteri, cause skin lesions recognized by physicians and victims alike in the southern and southeastern United States. Native fire ant stings are documented much less often. However, there is significant cross-reactivity among the venoms of Solenopsis species.

Conclusion: It is important for clinicians to recognize the characteristic skin lesions of fire ant envenomation as fire ant populations are expanding and they sting millions of people each year.