Imaginary Insect or Mite Infestations

  • Jerome Goddard
Part of the Infectious Disease book series (ID)


Imaginary insect or mite infestations, a condition called delusions of parasitosis (DOP), are not uncommon in the human population. Pest control technicians, entomologists, and physicians (especially dermatologists) frequently encounter these patients who complain of mystery bites or itches which they attribute to tiny insects or mites. Patients characteristically produce numerous samples containing tiny bits of debris, lint, hair, fibers, and sometimes scabs and skin. This chapter provides in-depth coverage of the condition of DOP, its various contributing factors, and treatment strategies. A related condition, Morgellons disease, is also presented and discussed.


Delusions of parasitosis Imaginary infestations Morgellons disease Mites Neurotic excoriation Pimozide Drug abuse Entomophobia Psychosomatic illness 


  1. 1.
    Koblenzer CS. The clinical presentation: diagnosis and treatment of delusions of parasitosis - a dermatologic perspective. Bull Soc Vector Ecol. 1993;18:6–10.Google Scholar
  2. 2.
    Hinkle N. Ekbom syndrome: the challenge of "invisible bug" infestations. Annu Rev Entomol. 2010;55:77–94.CrossRefGoogle Scholar
  3. 3.
    Thibierge G. Les acarophobes. Rev Gen Clin Ther. 1894;32:373–6.Google Scholar
  4. 4.
    Wilson JW, Miller HE. Delusion of parasitosis. Arch Dermatol Syphilol. 1946;54:39–56.CrossRefGoogle Scholar
  5. 5.
    Zanol K, Slaughter J, Hall R. An approach to the treatment of psychogenic parasitosis. Int J Dermatol. 1998;37:56–63.CrossRefGoogle Scholar
  6. 6.
    Monk BE, Rao YJ. Delusions of parasitosis with fatal outcome. Clin Exp Dermatol. 1994;19:341–2.CrossRefGoogle Scholar
  7. 7.
    Alexander JO. Arthropods and human skin. Berlin: Springer; 1984. p. 422.CrossRefGoogle Scholar
  8. 8.
    Bhatia MS, Jagawat T, Choudhary S. Delusional parasitosis: a clinical profile. Int J Psychiatry Med. 2000;30:83–91.CrossRefGoogle Scholar
  9. 9.
    Goddard J. Analysis of 11 cases of delusions of parasitosis reported to the Mississippi Department of Health. South Med J. 1995;88:837–9.CrossRefGoogle Scholar
  10. 10.
    Obermayer ME. Dynamics and management of self-induced eruptions. Calif Med. 1961;94:61–71.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Trabert W. 100 years of delusional parasitosis: meta-analysis of 1,223 case reports. Psychopathology. 1995;28:238–46.CrossRefGoogle Scholar
  12. 12.
    Elpern DJ. Cocaine abuse and delusions of parasitosis. Cutis. 1988;42:273–4.PubMedGoogle Scholar
  13. 13.
    Rieder E, Hamalian G, Maloy K, Streicker E, Sjulson L, Ying P. Psychiatric consequences of actual versus feared and perceived bed bug infestations: a case series examining a current epidemic. Psychosomatics. 2012;53:85–91.CrossRefGoogle Scholar
  14. 14.
    Pearson ML, Selby JV, Katz KA, Cantrell V, Braden CR, Parise ME, et al. Clinical, epidemiologic, histopathologic and molecular features of an unexplained dermopathy. PLoS One. 2011;7(1):e29908.CrossRefGoogle Scholar
  15. 15.
    Anonymous. Morgellons disease. Mayo Clinic health information factsheet,; 2011.
  16. 16.
    Mostaghimi L. Psychocutaneous medicine. In: Bope ET, Kellerman RD, editors. Conn's current therapy. Philadelphia: Elsevier; 2017. p. 963–8.Google Scholar
  17. 17.
    Goddard J. Physician's guide to arthropods of medical importance. 6th ed. Boca Raton: Taylor and Francis (CRC); 2013. p. 412.Google Scholar
  18. 18.
    Suh KN, Keystone JS. Delusional parasitosis. In: Guerrant RL, Walker DH, Weller PF, editors. Tropical infectious diseases: principles, pathogens, and Pratcice, vol. 2. 2nd ed. Philadelphia: Churchill Livingstone; 2006. p. 1700–7.Google Scholar
  19. 19.
    Goddard J. Imaginary insect or mite infestations. Inf Med. 1998;15:168–70.Google Scholar
  20. 20.
    Koblenzer CS. Psychocutaneous disease. Orlando: Grune and Stratton; 1987. p. 328.Google Scholar
  21. 21.
    Driscoll MS, Rothe MJ, Grant-Kels JM, Hale MS. Delusional parasitosis: a dermatologic, psychiatric, and pharmacologic approach. J Am Acad Dermatol. 1993;29:1023–33.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Jerome Goddard
    • 1
  1. 1.Extension Professor of Medical EntomologyMississippi State UniversityMississippi StateUSA

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