Concurrent Delusions of Ocular Parasitosis and Complex Visual Hallucinations from Charles Bonnet Syndrome Treated Successfully with Aripiprazole in an Elderly Male: A Case Report

Perm J. 2020 Dec;25:1-3. doi: 10.7812/TPP/20.132.ABSTRACTINTRODUCTION: Delusional parasitosis (DP) has been described as among the most challenging diagnosis to manage in dermatology and psychiatry literature. Patients with this perplexing and enigmatic condition present potentially to a wide range of specialties including primary or emergency care, dermatology, infectious diseases, neurology, and psychiatry. DP is probably underdiagnosed from patients' underreporting of symptoms of being infested with parasites, resulting from the associated social stigma. In addition, specialists who most often encounter these patients often possess low familiarity and comfort level in the diagnosis and therapy of this disorder. To our knowledge, we present only the fifth case of delusional parasitosis that was associated with complex visual hallucinations. Both concurrent conditions were treated successfully with aripiprazole. Interestingly, in all of these prior cases including ours, the patients were elderly (age range, 74-95 years). Delusions of ocular parasitosis has been described in fewer than 11 cases. When delusions occur concurrently with hallucinations, the differential diagnosis becomes even more challenging and may include schizophrenia, drug-induced psychosis, Lewy body dementia, and Charles Bonnet syndrome. Our patient's delusions of ocular parasitosis led to ocular damage and severe visual impairment because of his constant need to extract the parasites from his eyes. We spe...
Source: The Permanente journal - Category: General Medicine Authors: Source Type: research