A sixty-year-old man with a history of hypersensitivity reactions to insect bites, while working in the communal garden weeding, was bitten on the ulnar part of the dorsum of right hand by fire ants.1 Four of the bites were around the fourth metacarpophalangeal joint. Intense burning sensation was felt immediately at the site of the bite with rapid extension of burning and redness to surrounding areas and fingers. Swelling started immediately with a white spot at each bite site a little less than the size of a dime. Twelve vesicles developed mostly on the ulnar side of the dorsum of right hand. Within the hour, the dorsum of right hand swelled to double its size, with redness, and heat present.2 Skin tender to light touch. Itching sensation was felt in the vesicles. Swelling and heat was better with cold application. Vesicles the size of a small pea started oozing yellow non-purulent fluid without any particular smell, drying to a yellow crust on the skin.
Apis mellifica 200C, dry dose, orally, first dose on September 3rd in the evening was taken; then three dry doses one hour apart. No change was observed in the swelling, redness, or vesicles by that evening nor by the morning of the next day.
The morning of September 4th elderberry gummies with 50 mg of echinacea was taken by mouth. Ledum palustre 200C one dose was taken, and a thin slice of onion was placed on the vesicles producing a cooling sensation on the hand lasting for two hours thereafter. Ledum p. 200C, one dry dose was repeated again in 2 hours and again at 1 pm. Swelling, redness, and now heat on the dorsum of the right hand continued to get worse, extending to the posterior side of the forearm. Lymph glands on arm and axilla were not swollen.
Echinacea purpurea (coneflower) plant was found in the garden and applied locally, after lightly masticating the leaves, to each vesicle, breaking the vesicles during application. Swelling, redness, and heat of right hand began extending more than halfway up the dorsal side of the forearm and continued to worsen.
_______________ 200C was given at 6:15 pm, September 4th, resulting in an aggravation of symptoms within the hour followed with steady improvement thereafter.
(See page 33 of the Autumn 2024 AJHM for the answer.)
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