ABSTRACT
ABSTRACT Ekbom Syndrome, also known as parasitosis delusion or psychogenic parasitosis, is a rare condition in which patients present with a fixed belief of being infested by parasites, vermin or small insects, along with tactile hallucinations (such as pruritus or sensations of the parasites crawling over or under the skin). The syndrome may occur idiopathically or be associated with other medical conditions and drug use. This case report describes the occurrence of Ekbom syndrome in a patient diagnosed with Lewy Body Dementia (LBD), a neurodegenerative disease that commonly presents with sensory perception and thought disorders and other neuropsychiatric symptoms. Although visual hallucination is considered a core diagnostic criterion, other modalities of psychiatric symptoms can also occur posing a further challenge for correct diagnosis. Proper recognition allows early diagnosis and adequate treatment, preventing hazardous antipsychotic use in these patients.
RESUMO A síndrome de Ekbom, também conhecida como delírio parasitário ou parasitose psicogênica, é uma condição rara na qual os pacientes apresentam crença fixa de estarem infestados por parasitas, vermes ou insetos, acompanhada de alucinações táteis (como prurido ou sensação dos parasitas andando sobre ou sob a pele). A síndrome pode ocorrer de forma idiopática ou associada a outras condições médicas ou uso de drogas. Este relato de caso descreve a ocorrência da síndrome de Ekbom em um paciente diagnosticado com Demência com corpos de Lewy (DCL), uma doença degenerativa que comumente se apresenta com desordens de sensopercepção e pensamento, e outros sintomas neuropsiquiátricos. A alucinação visual é considerada um dos critérios diagnósticos nucleares, entretanto outras modalidades de sintomas psiquiátricos podem ocorrer criando desafios adicionais ao diagnóstico correto. O reconhecimento apropriado permite o diagnóstico precoce e tratamento adequado, prevenindo o uso arriscado de antipsicóticos nesses pacientes.
Subject(s)
Humans , Restless Legs Syndrome , Self Mutilation , Lewy Body Disease , Delirium , Dementia , Delusional ParasitosisABSTRACT
El síndrome de Ekbom también llamado delirio de parasitosis es una condición psiquiátrica poco frecuente en el que los pacientes tienen una idea falsa y fija de estar infestados por parásitos o materiales inanimados. Se presenta el caso de un varón de 54 años con cuadro crónico compatible con este síndrome en el que resalta la buena respuesta a antipsicótico típico a un inicio, complicándose el mismo con discinecia tardía por síntomas extrapiramidales, por lo que se realiza el cambio de tratamiento con buena respuesta a la Risperidona.
Ekbom's syndrome also called Delusional Parasitosis is a rare mental disorder in which patients have a false and fixedidea of being infested by parasites or inanimate materials. A case of a 54-year-old man with a chronic condition compatible with this syndrome is reported. Initially, a good response to typical antipsychotic was highlighted, however it got complicated by a tardive dyskinesia due to extrapyramidal symptoms. Consequently, change of treatment with risperidone resulted in good response.
Subject(s)
Parasitic DiseasesABSTRACT
Illusory parasitosis, better known as delusional parasitosis, is a neuropsychiatric syndrome in which patients have the belief of suffering a parasitic disease, that can not be demonstrated after an exhaustive medical study. These patients are characterized by being polyconsultants in different medical specialties and, many of them, have antecedents of psychiatric disorders, some of them undiagnosed. Knowing the existence of the clinical picture, diagnosing early and empathizing with the patient, could give to clinician some clues for a timely and assertive psychiatric referral, and improve patient adherence to the proposed treatment.
La parasitosis ilusoria, más conocida como delusión parasitaria, es un síndrome neuropsiquiátrico donde los pacientes tienen el convencimiento de padecer una infestación parasitaria, que no puede ser demostrada tras un exhaustivo estudio médico. Estos pacientes se caracterizan por ser policonsultantes en distintas especialidades médicas y, muchos de ellos, poseen antecedentes de trastornos psiquiátricos, algunos de ellos no diagnosticados. Conocer la existencia del cuadro, diagnosticar precozmente y empatizar con el paciente, pueden dar al médico clínico algunas claves para una derivación psiquiátrica oportuna y asertiva, y mejorar la adherencia del paciente al tratamiento propuesto. Se presentan cuatro casos clínicos que consultaron por esta extraña condición.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Skin Diseases, Parasitic/psychology , Delusional Parasitosis/diagnosis , Intestinal Diseases, Parasitic/psychology , Delusional Parasitosis/psychologyABSTRACT
El síndrome de Ekbom o delirio de parasitosis es una condición psiquiátrica infrecuente cuyo síntoma principal es la idea delirante de estar infestado con organismos vivientes, como parásitos, bacterias, virus, insectos o gusanos. Se presenta el caso de un varón de 34 años con un cuadro compatible con este síndrome. Se revisa brevemente la literatura disponible y se realiza una correlación teórico-clínica con los síntomas del paciente, y se concluye que el paciente sufría un síndrome de Ekbom de tipo primario y mixto.
The Ekbom syndrome or delusional parasitosis is an uncommon psychiatric condition, in which the main symptom is the delusion of being infested with living organisms such as parasites, bacteria, virus, bugs or worms. The case is presented of a 34 year-old man with symptoms compatible with the syndrome. The available literature is briefly reviewed and theoretical correlation with clinical symptomatology is made. The patient had a primary and mixed Ekbom syndrome.
Subject(s)
Adult , Humans , Male , Delusional Parasitosis/diagnosis , Delusional Parasitosis/classification , Delusional Parasitosis/psychology , Syndrome , Terminology as TopicABSTRACT
Introducción: El síndrome de Ekbom o delirio de parasitosis (DP) representa una psicosis monosintomática, poco frecuente, caracterizada por la creencia firme, por parte de quien la padece, de que está infestado, en contra de toda evidencia, por insectos, gusanos o piojos que habitan y dañan su piel. Los pacientes pueden ver seriamente afectado el trabajo diario o la vida social. Objetivos: Estudiar en profundidad a los pacientes con DP y aprender más de ellos. Método: Se aportan cinco casos: tres mujeres y dos hombres. Resultados: La duración media de los síntomas, hasta que llegaron por primera vez a la consulta, fue de 10 meses. Dos pacientes presentaban ideas delirantes de infestación cutánea y oral. Sentían lagartijas o pequeños organismos en sus bocas. Todos los pacientes fueron tratados con pimozida, pero solamente dos remitieron completamente. Posteriormente, dos pacientes se trataron con sulpiride y alcanzaron una remisión total. A otro paciente se le administró risperidona y remitió parcialmente. Los pacientes se evaluaron a los tres, seis y doce meses después del tratamiento. Conclusiones: Se resaltan las dificultades en el diagnóstico y en la elección de la terapéutica adecuada por parte del dermatólogo, quien se enfrenta al dilema de manejar un trastorno psiquiátrico en el campo dermatológico. Además, se ha comprobado que actualmente sólo existe un caso publicado en que coexisten ideas delirantes de infestación en piel y cavidad oral...
Introduction: Ekbom syndrome or delusional parasitosis (DP) represents a rare mono-symptomatic psychosis characterized by the delusional belief of the patient against all evidence, that he is infested by insects, worms or lice that damage his skin. Daily work and/or social activities may be seriously compromised. Objectives: To review cases of patients with DP in order to learn from them. Method: Five cases (3 men and 2 women) are reported. Results: Mean duration of symptoms at the time of the first assessement was 10 months. Two of the patients had delusions of oral and skin parasitosis. They felt small lizards and/or small organisms in their mouths. All of them were treated with pimozide, but only one had complete remission. Later, two of them were treated with sulpiride and achieved total remission. Risperidone was given to one patient, resulting in partial remission. All the patients were evaluated at 3, 6 and 12 months post-treatment. Conclusions: These findings highlight the difficulties encountered in diagnosing DP, in the lack of acceptance of the treatment by the patient, and in choosing the right psychotropic medication by the dermatologist who faces the dilemma of managing a psychiatric condition in a dermatological setting. To the best of our knowledge, there is only one previous report of coexisting delusions of oral and skin parasitosis to date...
Subject(s)
Dermatology , Restless Legs Syndrome/parasitologyABSTRACT
O presente relato tem por objetivo descrever o caso de uma paciente portadora de delírio de infestação parasitária comórbido com transtorno bipolar. Trata-se de paciente portadora de transtorno bipolar há mais de 30 anos e que se encontrava com quadro psíquico estabilizado e sem alterações do humor durante as consultas psiquiátricas. Em uma das suas avaliações periódicas, começou a se queixar da presença de vermes que estavam infestando seu corpo, o que já vinha ocorrendo há 8 anos. Estava em uso de carbonato de lítio e não aceitou tomar o antipsicótico prescrito porque já experimentara efeito colateral com essa classe de medicamentos. A associação entre delírio de infestação parasitária e transtorno bipolar é rara, e os autores encontraram apenas um caso semelhante descrito na literatura médica internacional.
The objective of the present report is to describe the case of a patient with delusional parasitosis comorbid with bipolar disorder. The patient had been diagnosed with bipolar disorder over 30 years ago and her mental state was stable without any mood disturbances detected during psychiatric visits. During one of her periodic evaluations, the patient started to complain that worms were infesting her body, which had been occurring for the past 8 years. She was taking lithium carbonate and refused to use an antipsychotic because she had experienced side effects after using this class of drugs. The association between delusional parasitosis and bipolar disorder is rare, and we found only one similar case described in the literature.
ABSTRACT
En el presente trabajo se da cuenta de la historia del síndrome delirante crónico conocido como "delirio de parasitosis o síndrome de Ekbom", sus principales características clínicas, evolutivas, la ubicación nosográfica y las estrategias terapéuticas utilizadas. Los hallazgos de la principal literatura publicada se comparan con la experiencia de los autores al haber estudiado doce pacientes portadores de esta sintomatología. Asimismo, se indaga acerca de la posible conexión con otros cuadros psicopatológicos, más específicamente con el espectro obsesivo-compulsivo.
In this paper, the history of the chronic delusional syndrome known as delusional parasitosis or Ekbom syndrome is reviewed as well as its main clinical characteristics, evolution, nosographic position and therapeutic approaches. The findings in the published literature are compared with the clinical experience of the authors who have studied twelve cases. The possible connection with other mental diseases, specifically Obsessive Compulsive Spectrum, is evaluated.
Subject(s)
Humans , Male , Female , Middle Aged , Aged, 80 and over , Delusions/psychology , Parasitic Diseases , Restless Legs Syndrome , Delusions/diagnosis , Delusions/therapy , Pimozide , Restless Legs Syndrome/diagnosis , Restless Legs Syndrome/therapyABSTRACT
O delírio parasitário (ou síndrome de Ekbom) é uma condição rara, onde o paciente apresenta uma forte convicção de que está infestado por pequenos parasitas ou organismos. Muitas vezes, os delírios são tão intensos que levam esses pacientes à automutilação. Relatamos aqui um caso de um senhor de 67 anos, isolado socialmente, solteiro, apresentando delírio parasitário em região perineal, culminando em lesões por automutilação.
Delusional parasitosis (or Ekbom's syndrome) is a rare condition, in which the patient has a strong conviction that he or she is infested by small parasites or organisms. These delusions are often so intense that they lead the patient to self-mutilation. We report a case of a 67-year-old man, socially isolated, single, with delusional parasitosis in the perineal area, culminating in self-mutilation lesions.