Delusional parasitosis. A multicenter retrospective study in Spanish infectious disease services

Delusional parasitosis or Ekbom syndrome is a condition described mainly in the fields of psychiatry and dermatology, with a complex diagnostic and therapeutic approach. However, it is uncommon to assess patients with this disease in infectious disease units. The objective of this work is to describe the experience of three infectious diseases departments with respect to this entity. A retrospective descriptive study of 20 patients diagnosed with delusional parasitosis in three Infectious Diseases Services was performed between 2003 and 2017. The median age of the patients was 54 years, with a female/male ratio of 1.5:1. In 9 patients, an endoparasitic delirium (mainly digestive) was described, in 5 an ectoparasitic form was described, and in the remaining 6, a mixed form was described. Fourteen patients presented some type of psychiatric disorder. Four patients had alcohol or drug abuse disorder. All patients had made consultations to other specialties with a median of three per patient (range 1–7). Ten patients received “empirical” antiparasitic treatment and 8 received some type of psychopharmaceutical treatment. The evolution was very variable: in 3 patients, the delusional parasitosis was resolved; in 9 patients, the clinical manifestations persisted, and the remaining patients were lost to follow-up. Ekbom syndrome is a common process in infectious diseases, presenting some differences with other series evaluated by dermatologists and psychiatrists. Management of this disease should promote a multidisciplinary approach to enable a joint treatment, thus optimizing patient management and therapeutic adherence. La parasitosis delirante o síndrome de Ekbom es una afección descrita principalmente en los campos de la psiquiatría y la dermatología, con un enfoque diagnóstico y terapéutico complejo. Sin embargo, es poco frecuente evaluar a los pacientes con esta enfermedad en unidades de enfermedades infecciosas. El objetivo de este trabajo es describir la experiencia de 3 departamentos de enfermedades infecciosas con respecto a esta entidad. Entre 2003 y 2017 se llevó a cabo un estudio descriptivo retrospectivo de 20 pacientes a los que se les diagnosticó parasitosis delirante en 3 servicios de enfermedades infecciosas. La mediana de edad de los pacientes era de 54 años, con una proporción mujeres/varones de 1,5:1. En 9 pacientes se describió un delirio endoparasitario (principalmente digestivo), en 5 se describió una forma ectoparasitaria y en los 6 restan