Delusional infestation

a case report of six patients

Authors

DOI:

https://doi.org/10.15448/1980-6108.2025.1.47562

Keywords:

Delusional infestation, delusional parasitoses, Ekbom delusional parasitoses, psychogenic parasitosis.

Abstract

Delusional infestation, or delusional parasitosis, is a psychosis characterized by the strong impression of being infested by a living organism. Patients do not present with manifestations other than delusional disorders, but psychiatric conditions are common, especially depression. The authors report a case series of six patients with delusional infestation treated at a reference service for infectious diseases. All patients had a history of previous medical visits and had undergone various parasitological treatments. Resistance to admit a delusional etiology is a constant in these patients, and because of this resistance, five patients abandoned follow-up. Only one patient showed some improvement in symptoms with the prescribed antipsychotics. Managing delusional infestation is a challenge, and the care and efforts of a multidisciplinary team are required.

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Author Biographies

Sidnei Silva, Evandro Chagas National Institute of Infectious Diseases (FIOCRUZ), Rio de Janeiro, RJ, Brazil.

Master's degree in Parasitic Biology from the Oswaldo Cruz Institute (IOC-FIOCRUZ), Oswaldo Cruz Foundation, in Rio de Janeiro, RJ, Brazil. Technologist in Public Health at INI-FIOCRUZ in Rio de Janeiro, RJ, Brazil.

Celina Mannarino, Evandro Chagas National Institute of Infectious Diseases (FIOCRUZ), Rio de Janeiro, RJ, Brazil.

Doctor of Psychiatry and Mental Health from the Federal University of Rio de Janeiro (UFRJ) in Rio de Janeiro, RJ, Brazil. Researcher at INI-FIOCRUZ in Rio de Janeiro, RJ, Brazil.

Gisele Silva Dias, Evandro Chagas National Institute of Infectious Diseases (FIOCRUZ), Rio de Janeiro, RJ, Brazil

Biomedical Scientist from Castelo Branco University (UCB) in Rio de Janeiro, RJ, Brazil. Laboratory Analyst at INI-FIOCRUZ in Rio de Janeiro, RJ, Brazil.

Clarisse da Silveira Bressan, Evandro Chagas National Institute of Infectious Diseases (FIOCRUZ), Rio de Janeiro, RJ, Brazil.

Doctor en Investigación Clínica en Enfermedades Infecciosas del Instituto Nacional de Enfermedades Infecciosas Evandro Chagas (INI-FIOCRUZ), Fundación Oswaldo Cruz, Río de Janeiro, RJ, Brasil. Investigador del INI-FIOCRUZ en Río de Janeiro, RJ, Brasil.

Leonardo Imenes de Pinho, Evandro Chagas National Institute of Infectious Diseases (FIOCRUZ), Rio de Janeiro, RJ, Brazil

Physician graduated from the Federal University of the State of Rio de Janeiro (UNIRIO) in Rio de Janeiro, RJ, Brazil. Infectious disease physician at INI-FIOCRUZ in Rio de Janeiro, RJ, Brazil.

Graziela Maria Zannini, Evandro Chagas National Institute of Infectious Diseases (FIOCRUZ), Rio de Janeiro, RJ, Brazil

Doctor of Parasitic Biology from the Oswaldo Cruz Institute (IOC-FIOCRUZ), Oswaldo Cruz Foundation, in Rio de Janeiro, RJ, Brazil. Researcher at INI-FIOCRUZ in Rio de Janeiro, RJ, Brazil.

Elizabeth de Souza Neves, Evandro Chagas National Institute of Infectious Diseases (FIOCRUZ), Rio de Janeiro, RJ, Brazil.

Doctor of Clinical Research in Infectious Diseases from the Evandro Chagas National Institute of Infectious Diseases (INI-FIOCRUZ), Oswaldo Cruz Foundation, in Rio de Janeiro, RJ, Brazil. Researcher at INI-FIOCRUZ in Rio de Janeiro, RJ, Brazil.

References

Campbell EH, Elston DM, Hawthorne JD, Beckert DR. Diagnosis and management of delusional parasitosis. J Am Acad Dermatol [Internet]. 2019 May [citado 2025 out 30];80(5):1428-34. Disponível em: https://doi.org/10.1016/j.jaad.2018.12.012. DOI: https://doi.org/10.1016/j.jaad.2018.12.012

Rodríguez-Alonso B, Álvarez-Artero E, Martínez-Goñi R, Almeida H, Casado-Espada NM, Jaén-Sánchez N, et al. Delusional parasitosis. A multicenter retrospective study in Spanish infectious disease services. Enf Infec y Microbiol Clín [Internet]. 2021 [citado 2025 out 30];39(5):223-28. Disponível em: https://doi.org/10.1016/j.eimc.2020.07.009. DOI: https://doi.org/10.1016/j.eimc.2020.07.009

Reich A, Kwiatkowska D, Pacan P. Delusions of Parasitosis: An Update. Dermatol Ther (Heidelb) [Internet]. 2019 [citado 2025 out 30];9(4):631-38. Disponível em: https://doi.org/10.1007/s13555-019-00324-3. DOI: https://doi.org/10.1007/s13555-019-00324-3

Martins AC, Mendes CP, Nico MM. Delusional infestation: a case series from a university dermatology center in São Paulo, Brazil. Int J Dermatol [Internet]. 2016 Aug [citado 2025 out 30];55(8):864-8. Disponível em: https://doi.org/10.1111/ijd.13004. DOI: https://doi.org/10.1111/ijd.13004

Dalgalarrondo P. O juízo da realidade e suas alterações (o delírio). In: Dalgalarrondo P, editor. Psicopatologia e semiologia dos transtornos mentais. 3ª ed. Porto Alegre: Artes Médicas Sul; 2019. Capítulo 21.

Amato-Neto V, Amato JG, Amato VS, Ferreira CS. Ekbom syndrome (delusory parasitosis): ponderations on two cases. Rev Inst Med Trop Sao Paulo [Internet]. 2007 [citado 2025 out 30];49(6):395–6. Disponível em: https://doi.org/10.1590/S0036-46652007000600012. DOI: https://doi.org/10.1590/S0036-46652007000600012

Mumcuoglu KY, Leibovici V, Reuveni I, Bonne O. Delusional parasitosis: diagnosis and treatment. Isr Med Assoc J [Internet]. 2018 [citado 2025 out 30];20(7):456–60. Disponível em: https://pubmed.ncbi.nlm.nih.gov/30109800/.

Soares FA, Benitez ADN, Santos BMD, Loiola SHN, Rosa SL, Nagata WB, et al. A historical review of the techniques of recovery of parasites for their detection in human stools. Rev Soc Bras Med Trop [Internet]. 2020 [citado 2025 out 30];53:e20190535. Disponível em: https://doi.org/10.1590/0037-8682-0535-2019. DOI: https://doi.org/10.1590/0037-8682-0535-2019

Hylwa SA, Bury JE, Davis MD, Pittelkow M, Bostwick JM. Delusional infestation, including delusions of parasitosis: results of histologic examination of skin biopsy and patient-provided skin specimens. Arch Dermatol [Internet]. 2011 [citado 2025 out 30];147(9):1041–45. Disponível em: https://doi.org/10.1001/archdermatol.2011.114. DOI: https://doi.org/10.1001/archdermatol.2011.114

Guedes NL, Dwan AJ, Guerlero P, Nico MM. Delusional infestation treated with risperidone: a series of 27 patients. Clin Exp Dermatol [Internet]. 2024 [citado 2025 out 30];49(4):364–67. Disponível em: https://doi.org/10.1093/ced/llad411. DOI: https://doi.org/10.1093/ced/llad411

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Published

2025-12-04

How to Cite

Silva, S., Mannarino, C., Silva Dias, G., da Silveira Bressan, C., Imenes de Pinho, L., Zannini, G. M., & Neves, E. de S. (2025). Delusional infestation: a case report of six patients. Scientia Medica, 35(1), e47562. https://doi.org/10.15448/1980-6108.2025.1.47562

Issue

Vol. 35 No. 1 (2025): Single Volume

Section

Case Reports

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Copyright (c) 2025 Sidnei Silva, Celina Mannarino, Gisele Silva Dias, Clarisse da Silveira Bressan, Leonardo Imenes de Pinho, Graziela Maria Zannini, Elizabeth de Souza Neves

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This work is licensed under a Creative Commons Attribution 4.0 International License.