Emergency Medical Minute13 Okt 2025

Episode 978: Delusional Parasitosis

Contributor: Taylor Lynch, MD

Educational Pearls:

Delusional parasitosis is a subtype of the psychiatric condition delusional disorder
- Defined as a fixed, false belief of infestation by parasites or other organisms
- A somatic type of delusional disorder
Primary delusional parasitosis
- Occurs in the absence of other psychiatric or medical conditions
Secondary delusional parasitosis
- Causes include methamphetamine use disorder, schizophrenia, neurologic diseases, or medical conditions such as thyroid disease
Pathophysiology
- Poorly understood
- Upregulation of striatal dopamine system is implicated
Management
- Form a strong therapeutic alliance and do not discredit the patient immediately
- Perform a full physical exam
  - This helps reassure the patient and strengthen the therapeutic alliance
  - Some day there may be a patient in whom this is not a delusion
Treatment & Management
- Discontinuation of substances if substance-induced
- Antipsychotic medications like risperidone or olanzapine

References

Lepping P, Russell I, Freudenmann RW. Antipsychotic treatment of primary delusional parasitosis: systematic review. Br J Psychiatry. 2007;191:198-205. doi:10.1192/bjp.bp.106.029660
Moriarty N, Alam M, Kalus A, O'Connor K. Current Understanding and Approach to Delusional Infestation. Am J Med. 2019;132(12):1401-1409. doi:10.1016/j.amjmed.2019.06.017
Skelton M, Khokhar WA, Thacker SP. Treatments for delusional disorder. Cochrane Database Syst Rev. 2015;2015(5):CD009785. Published 2015 May 22. doi:10.1002/14651858.CD009785.pub2

Summarized and Edited by Jorge Chalit, OMS4

Donate: https://emergencymedicalminute.org/donate/

Det här avsnittet är hämtat från ett öppet RSS-flöde och publiceras inte av Podme. Det kan innehålla reklam.

Avsnitt(1166)

Podcast 1011: Creepy Crawlies

Contributor: Meghan Hurley, MD Educational Pearls: What animal is the most lethal to humans? Depending on how we define lethal, and animal, this answer is actually not straight forward. Globall...

6 Juli 7min

Podcast 1010: First Pass Intubation Success

Contributor: Travis Barlock, MD Educational Pearls: First-pass success is critical to limit complications from apnea, hypoxia, and airway trauma. Complication rate for patients intubated on the f...

29 Juni 3min

On the Streets- Zero to Rodeo

Dan Orbidan, OMS-II and Dr. Travis Barlock, MD discuss a real out of hospital call. This episode covers the implications of a pharmacologically abnormal patient presentation and the pre and post hospi...

22 Juni 35min

Carepoint Journal Club- Neurology

Carepoint Journal Club is a quarterly series with discussions about a medical topic, brought to you by Carepoint's Emergency Physicians.

15 Juni 36min

Podcast 1009: Prevention for Recurrent UTI

Contributor: Aaron Lessen, MD Educational Pearls: UTIs are commonly seen in older women We often see them taking long-term prophylactic antibiotics because of common recurrence. Around 20-30% of...

8 Juni 1min

Podcast 1008: Acupuncture for Low Back Pain in Older Adults

Contributor: Aaron Lessen, MD Educational Pearls: Back pain is a common presenting complaint in the emergency department. Challenges arise when tailoring care to elderly populations using standar...

1 Juni 2min

Podcast 1007: Caffeine Pharmacology

Contributor: Travis Barlock, MD Educational Pearls: Caffeine Geography and Types: Caffeine is found throughout the world and has evolved independently in various plants that are not evolutionarily...

25 Maj 4min

Podcast 1006: Cannabinoid Pharmacology

Contributor: Travis Barlock, MD Educational Pearls: Endocannabinoid System: THC binds CB1 and CB2 receptors in neurons and immune cells Δ9-Tetrahydrocannabinol (THC) is the main psychoactive compo...

18 Maj 5min