Medically important ants: a systematic review of the global distribution and clinical consequences of their bites and stings

Abstract

Introduction: From the medical point of view, only some ants are of special interest. Due to the diversity of ants and the growing contact with humans, it is necessary to have a better understanding of the factors and problems, which lead to adverse clinical outcomes.

Objective: The aim of this study was to conduct a systematic review of published studies on ants and their impact on the medical field to synthesize fragmented knowledge and to inform the current state of this problem.

Methods: A systematic literature review was conducted in Medline, EMBASE, SciELO and Google Scholar, with no time threshold. The search strategy was limited to articles published in Portuguese, English and Spanish. Eligible studies were case reports and case series that reported outcomes in humans caused by ant stings. Patient-level and study-level information was extracted.

Results: The literature search yielded 1909 studies; of which 30 case reports and 16 case series reporting a total of 95 cases were included. Of these 48 patients were women (50.5%), and the median age was 36.1 ± 25.5 years old. The most frequently reported complications were severe pain, anaphylaxis and acute respiratory distress syndrome. The death of eighteen patients was documented (18.9%). Ants from the genera Solenopsis spp., Myrmecia sp., Paraponera clavata, Pachycondyla sennaarensis, Myrmecia rubra caused most of the accidents

Conclusions: Severe allergic reactions caused by ants are a rare event, however, mortality can be high. An increase of ant related accidents is expected, a quick diagnosis and treatment is necessary to avoid fatalities.