![Sample our Behavioral Sciences journals, sign in here to start your access, latest two full volumes FREE to you for 14 days]({"type":"image" , "src" : "/sda/110801/TOC-Subject-Sample-2021-Behavioral-Sciences.jpg"})
Abstract
Objective: To provide a differential diagnosis and recommendations for care for an individual with suspected delusional parasitosis secondary to human immunodeficiency virus (HIV). Method: A 62-year-old male with sexually acquired, chronic, and well-managed HIV infection was referred for neuropsychological evaluation and treatment recommendations following extensive self-manipulation of a sternoclavicular cystic mass and superficial skin lesions over most of his body. The patient reported that he had pulled long calcified tendrils out of the mass over a period of several weeks and that “encapsulated fat” was flowing beneath his skin. Results: Numerous lab panels were negative for any acute medical pathology. Clinical neuroimaging was unremarkable. Neuropsychological evaluation revealed a profile consistent with mild neurocognitive disorder due to HIV. Medical and behavioral recommendations were made for the management of delusional thought processes consistent with atypical delusional parasitosis and other symptoms. The patient was responsive to carefully crafted provider feedback and his delusional and somatic symptoms decreased significantly with risperidone. Conclusions: This case illustrates the utility of neuropsychological assessment and provider feedback in the diagnosis and care of HIV-related neurocognitive disorder, the context of a delusional disorder.