Abstract
Although the practice of infectious diseases involves a broad range of surgical and medical disciplines, interactions with psychiatry are infrequent. Delusional infestation is a condition where an individual has a firmly fixed false belief that they have an infection. Delusional infestation challenges the infectious diseases specialist who must diligently rule out the presence of a true infection. However, perhaps, more importantly, we may need to initiate therapy with neuroleptic medications for which we may have little specific knowledge and experience. In this note we review the diagnosis and management of patients with delusional infestation.
Highlights
Delusional infestation is a condition where an individual has a firmly fixed false belief that they are infested with an infectious agent
Delusional infestation is preferred to the narrower term of delusional parasitosis as patients may report being affected by a range of nondescript or specific vermin, insects, parasites, fungi, bacteria, or viruses [1,2,3,4,5,6]
In primary delusional infestation a patient will have no underlying or prior psychiatric disorder and the delusion is not related to an organic cause or substance abuse
Summary
Delusional infestation is a condition where an individual has a firmly fixed false belief that they are infested with an infectious agent. While the delusional symptomatology may include any body system, most frequently patients will report formication or sensations of movement or other phenomena associated with the skin. While it is not uncommon for individuals from time to time to believe that they may have an infection, this must be differentiated from the case where this belief is intrusive and persists despite a lack of compelling supportive evidence. In primary delusional infestation a patient will have no underlying or prior psychiatric disorder and the delusion is not related to an organic cause or substance abuse. Secondary delusional infestation is related to either an underlying psychiatric or medical disorder or substance abuse. Cocaine, methamphetamines, tetrahydrocannabinol, and other illicit substances have been associated with secondary delusional infestation [10]
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