Delusional Parasitosis as a Presenting Feature of HIV Dementia: A Case Study

Abstract

Delusional parasitosis (DP) is a rare form of somatic delusions where a person believes that he or she is infected with worms, bugs, or other parasites. In the literature, DP has been discussed as a presenting feature of cortical dementias but has not been documented as a presenting feature in subcortical dementias such as HIV-associated dementia. We present a case of a 56-year-old male referred from the dermatology clinic for neuropsychological assessment after presenting with persisting claims that he was infected with “bugs” despite evidence to the contrary. The patient had a history of HIV and substance abuse. The patient was diagnosed with dementia due to HIV disease and psychosis due to dementia (i.e., DP) based on the neuropsychological evaluation. This case report suggests that neuropsychological evaluations may be indicated for patients presenting with DP and risk factors for either cortical or subcortical dementias such as HIV-associated dementia.

Key words:

• delusional parasitosis
• HIV
• HIV associated dementia
• somatic delusions

Notes

^a Raw Score – not converted into standardized scores. Interpretations based on raw scores.

^b Standard Score: M = 100; SD = 15.

^c Scaled Score: M = 10; SD = 3.

^d t-score, M = 50; SD = 10.

*Citations listed in order presented in table: MoCA (Nasreddine et al., 2005), IHDS (Sacktor et al., 2005), WASI (Psychological Corporation, 2001), RBMT (Wilson et al., 1985), DRS-2 (Jurica et al., 2001), verbal fluency tests (Heaton et al., 2004), TMT-A and TMT-B (Reitan, 1955); and psychomotor and sensory functioning (Reitan & Wolfson, 1985).