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Delusional infestation: are you being bugged?

Authors Thakkar A, Ooi KG, Assaad N, Coroneo M

Received 25 October 2014

Accepted for publication 22 December 2014

Published 2 June 2015 Volume 2015:9 Pages 967—970


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Angeli Thakkar, Kenneth GJ Ooi, Nagi Assaad, Minas Coroneo

Department of Ophthalmology, Prince of Wales Hospital, Sydney, NSW, Australia

Abstract: This case report documents a 58-year-old male who presented to the clinic with a 12-month history of a burrowing sensation in his eyelids that he attributed to a parasitic infestation. After being extensively investigated and reviewed by relevant specialties, no evidence of parasitic infestation was found. He was diagnosed with and treated for blepharitis. Psychiatric referral for presumed delusional infestation (DI) was recommended. Despite this, he remained insistent in his belief of infestation, and was inevitably lost to follow-up. DI, previously known as delusional parasitosis, is a rare delusional disorder where affected individuals have a fixed, false belief that they have a parasitic infestation. Diagnosis can be challenging. Practitioners need to evaluate between primary and secondary DI carefully, as management differs depending on the etiology. Despite this, patients diagnosed with primary DI tend to be resistant to psychiatric referral. This report aims to optimize management by giving the reader a guideline for appropriate investigations and advice on patient approach. It is important to recognize hallmark features of DI to minimize self-inflicted trauma and associated psychosocial consequences. Effective treatment for DI is available, and devastating consequences, including blindness, can be avoided.

Keywords: delusions, parasitosis, infestation, ocular trauma

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