Ekbom syndrome: Delusional Parasitosis

Delusional parasitosis, also known as Ekbom’s Syndrome, refers to a patient who mistakenly believes that his body is infested with parasites. These delusions can include an individual’s erroneous belief that he is inhabited by mites, fleas, lice, worms, bugs, bacteria and other various parasitic organisms. Typically a rare and uncommon syndrome, delusional parasitosis is becoming increasingly more relevant, especially with the rise of methamphetamine drug abuse, nicknamed “meth mites” or “cocaine bugs.”

Symptoms of Ekbom syndrome

1. May claim to have had this condition for an extended period of time.
2. Have been evaluated by several doctors.
3. May have employed the services of several exterminators, entomologists, parasitologists or hygienists.
4. May bring collections of human tissue, scabs, toilet paper, dust, lint, etc. to their appointments, known as the “matchbox sign.”
5. May have wounds as a result of self-mutilation in an attempt to extract the parasites from their skin or body.
6. May steer away from prescription drugs and rely instead on their own home remedies.
7. May expose themselves to toxic levels of pesticides.

People suffering from delusional parasitosis may describe the parasite infestations as being in various locations, including:

• Under the skin
• On or in the skin
• In or around the body openings
• Within sputum
• Within the stomach and intestines
• Inside their home

Causes of Delusional Parasitosis

The three sub-types are:

Primary Psychotic Delusional Parasitosis – the only psychological disturbance is delusional parasitosis. Persons typically act in an otherwise normal fashion and have the ability to reason in a rational way.

Secondary Functional Delusional Parasitosis –

• Schizophrenia
• Paranoia
• Depression
• Anxiety
• Obsessive compulsive disorder

Secondary Organic Delusional Parasitosis –

• Cancer
• Hypothyroidism
• Tuberculosis
• Drug abuse
• Diabetes
• Neurological impairment
• B12 vitamin deficiency
• Side effects of prescription drugs

Risk Factors of Ekbom syndrome

Delusional parasitosis can occur in people of any age, but instances are higher among middle-aged or elderly women and young men with a history of abuse of methamphetamines or cocaine. There are other risk factors including:

1. Young females who are divorced and have children
2. Young women with a history of drug abuse
3. Young women suffering with stress
4. Low income or unemployment
5. Drug abuse typically that of cocaine or methamphetamines
6. Compulsive cleaning
7. Being a female
8. Another family member or members shares in this mistaken belief of infestation

Diagnostic Tests for Ekbom syndrome

• Thyroid function tests, blood count, skin scraping and biopsies, B12 levels, chemistry profile.
• Diagnostic tests to rule out any underlying medical conditions that may present with skin problems
• Rule out real parasite infestations
• Rule out allergies or skin conditions
• Identify any history of drug abuse

Treatment Options

Medications may include, Antipsychotic: olanzapine or risperidone are used as first line treatment.