Delusional parasitosis in neurological patients.

OBJECTIVE: Delusional parasitosis has been described in a wide range of patients with general medical conditions, but there are few reports about its frequency and possible pathogenic mechanisms in neurological patients. This paper describes this delusional syndrome in a sample of neurological patients. METHODS: We reviewed all clinical charts of hospitalized patients at the neuropsychiatry ward of a neurological center, from January 2005 to June 2009. Cases with delusional parasitosis were described in terms of demographic, clinical and brain imaging features. RESULTS: From a total sample of 1598 patients, we identified 636 patients with neurological disease (39.80%); of these, four patients showed delusional parasitosis (0.62% of the neurological sample). Their diagnoses were brain cysticercosis (n=1), cerebrovascular disease (n=2), and dementia due to vitamin B12 deficit (n=1). They were women in late life, with depressive features. Three of them had significant cognitive decline. Two of them had paraesthesia and pruritus related to peripheral neuropathy. One of them had pruritus of unknown origin (possibly hallucinatory). CONCLUSIONS: Delusional parasitosis was infrequent in this sample of hospitalized neurological patients. Female sex, advanced age, depressive features, cognitive decline, pruritus and paraesthesia of peripheral or central origin may contribute to delusional parasitosis in this population.

Hábitos y creencias sobre parásitos y enfermedades parasitarias en habitantes de Santa Ana de los Guácaras, Corrientes, Argentina / Habits and beliefs about parasites and parasitic diseases among inhabitants of SantaAna de los Guácaras, Corrientes, Argentina

El objetivo del presente trabajo fue analizar las creencias populares que tienen los pobladores de la localidad de Santa Ana de los Guácaras, corrientes, Argentina sobre los parásitos y las enfermedades producidas por éstos y conocer los hábitos sanitarios en relación con las parasitosis. Se realizó un estudio de corte cualitativo. Se relevaron 39 hogares seleccionados de modo accidental en los que se aplicó una entrevista no estructurada al padre o madre de familia sobre los conocimientos acerca de los parásitos y las enfermedades que producen, síntomas y efectos, modos de prevención, transmisión, tratamiento y sobre hábitos sanitarios. El análisis de los datos se realizó conforme a la perspectiva de abordar el proceso de salud-enfermedad en función de las dimensiones propias de la esfera de la subjetividad. Para los pobladores la enfermedad parasitaria tiene una acepción restringida pues descartan las ectoparasitosis, las parasitosis infantiles son asumidas como naturales, lo que conduce a una actitud fatalista, que a su vez conlleva a no emprender estrategias de control. Se observa una inversión de las cadenas causales, hecho que provocan rupturas a la hora de relacionar todos los elementos vinculados en los ciclos de enfermedades parasitarias. Con este aporte se espera brindar herramientas para la comprensión sobre la permanencia de las parasitosis en Santa Ana de los Guácaras a fin de definir estrategias de previsión y control.

The purpose of the present work was to analyze the popular beliefs that people of Santa Ana de los Guácaras, Corrientes, Argentina, have on parasites and diseases they produce. Additionally, their health habits related to were investigated. A qualitative study was carried out. Thirty nine dwellings were randomly selected and a non structured interview was conducted with the father or mother of the family to investigate their knowledge on parasites and diseases that produce, symptoms and effects, methods of prevention, transmission, treatment and health habits. Data analysis was performed according to the perspective of addressing the health-disease process in accordance with the realm of their subjectivity. Results showed that parasitoses have a restricted meaning, since people do not take into account ectoparasites and parasitic diseases in children are assumed as natural, which leads to a fatalistic attitude, that in turn leads to not taking any control measures. There is a reversal of the causal chains, which cause breaks to relate all the elements linked to the cycles of parasitic diseases. This contribution is expected to provide tools for understanding the persistence of parasitic diseases in Santa Ana de los Guácaras and consequently, to define strategies for prevention and control.

[Delusional parasitic infestation and folie à deux: case report]. / Delírio de infestação parasitária e folie á deux: relato de caso.

Shared psychiatric disorder (folie deux) is a rare condition. But its prevalence can be 5-25% in patients with delusional parasitic infestation. We report the a case of a 62 years-old female with psychotic symptoms. For 15 years, she has lived with her younger sister. Since the patient was well-controled, her sister interrupted her antipsychotic drug administration. So, the patient initiated delusional parasitic infestation accompanied by visual hallucinations. Her sister, who did not have psychiatric history, initiated to believe that the patient was really infested. Moreover, she started to believe that was infested by the patient. This case report aims to discuss the relation between folie deux and delusional parasitic infestation.

[Ekbom's sydrome and spasmodic torticollis: case report]. / Síndrome de Ekbom e torcicolo espasmódico: Relato de caso.

The Ekbom's syndrome, also known as delirium of parasitic infestation, acarophobia, delusional parasitosis, psychogenic parasitosis, is a disease of rare occurrence. Generally it is characterized by the firm conviction of the patients to be infected by worms that come out of the skin, usually from the scalp or even from the mouth, from the eyes or from the genital region. Most of the patients are elderly and female, and with frequent social isolation. Some cases are associated with organic diseases as hyperthyroidism, diabetes, cortical lesion, intoxication by medicines. To our knowledge the association between delusional parasitosis with spasmodic torticollis was not described in literature. We report the case of a 72-year-old-woman with delusional parasitosis associated with spasmodic torticollis.

Sindrome de Ekbom como manifestacao prodromica de demencia / Ekbom's syndrome as prodromal manifestation of dementia

Os autores relatam o caso de uma paciente com delirio de infestacao parasitaria (sindrome de Ekbom), que evoluiu com deterioracao cognitiva importante. A paciente recebeu o posterior diagnostico de demencia...

[Expectations of hospitalized patients as to their relationship with the nursing team]. / Expectativas dos clientes hospitalizados frente ao relacionamento com a equipe de enfermagem.

This research has been made in infectious-parasitary disease sector of a public university hospital in Rio de Janeiro on the first semester of 1995. The logbook research has been introduced to 5 adult clients, from both sexes, who had been interned in the construction of two categories, which are: a) Category I: Feelings and expectations of the client and; b) Category II: Communication and relationship between client and nurse. The results found in the first category were: 1) Lack of affection; 2) Affection, fear and anxiety; 3) Loneliness and depression; 4) Reflection; 5) Insecurity; 6) Worry about the equipment, to be cut, to be impersonally treated, lose self-control and physical dependence. The results found in the second category were: 1) Doubts and interests in information about their disease, its evolution and how long they will stay in hospital: 2) Opportunity to express feelings and ideas; 3) Comprehension of the message given by the nurse. We emphasize the increase of interchange of information, ideas, beliefs, feelings and acts in nurse-client interaction to develop the therapeutic relationship aiming at helping the client to fulfill his basic needs.