Abstract
Hymenoptera stings can lead to a different range of local and systemic reactions. However, rare and unexpected reactions can develop and may be life threatening. In this paper, we present a 29-year-old female who developed anaphylactic shock followed by paraparesis and paraesthesia after a black ant sting. Her symptoms completely resolved after treatment with plasma exchange. Several studies have linked these neurological complications to delayed immunological reactions that are triggered by insect antigen. LEARNING POINTS: Environmental antigen exposure can present with immediate and delayed reactions.Weakness and paraesthesia are an unusual presentation reported after an ant sting that might be triggered due to an immunological response to an antigen, or antigen that directly causes neurotoxicity.Plasmapheresis might be an option for management of unexplained acute paraparesis and paraesthesia.