Title: Delusional Infestation-An Inanimate Presentation.

BACKGROUND: Delusional Infestation is characterized by patients' fixed belief that their skin and body is infested by small,vivid(or less frequently inanimate)pathogens,although there is no medical or microbiological evidence for this. It is a type of Somatic Delusion. CASE REPORT: 63year old female,referred by dermatologist with complaints of being infested with both animate and inanimate particles and itching all over the body from 6months. She was preoccupied with multiple somatic sensations all over her body. She reported that these particles were being emitted from her orifices like ears,eyes,nose,and skin pores. These particles penetrated her bones and were crushing them in to powder. The animate ones flowed through her skin and would be found on the place where she sits. These would get collected in clusters under her skin and she could feel them as nodules. Patient also had symptoms of mild depressive disorder secondary to these symptoms. There was a positive Specimen(Match box)sign observed. RESULTS: Diagnosis of Persistent delusional disorder- infestation type with mild depressive disorder was made and was treated with antipsychotics.20% improvement in the symptoms was reported a week later. CONCLUSION: This patient has been experiencing primary delusional infestation. She has continued to present to many different specialists with her complaints and is adamant about the presence of these particles. Due to the very low prevalence of this disorder,it is valuable to document it in order to understand and treat this phenomenon.