Citation

Trager MJ, Hwang TN, McCulley TJ. Ophthal. Plast. Reconstr. Surg. 2008; 24(4): 317-319.

Affiliation

Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA.

Copyright

(Copyright © 2008, American Society of Ophthalmic Plastic and Reconstructive Surgery, Publisher Lippincott Williams and Wilkins)

DOI

10.1097/IOP.0b013e31817e8ae3

PMID

18645444

Abstract

The authors describe preseptal cellulitis and corneal ulceration due to secondary infection of self- inflicted wounds in a patient with delusions of parasitosis. A 42-year-old man presented with a 3-day history of progressive painful, purulent, periocular erythema. He reported that "little black bugs and whitish eggs" had infiltrated his body including the left eye and eyelids. On examination, he was agitated with superficial wounds covering the majority of his body. Ophthalmic evaluation was notable for markedly erythematous and mildly edematous eyelids resulting in complete blepharoptosis. Excoriations with yellow-brown serous crusting carpeted the periocular region. A 1-mm pericentral corneal ulcer was also noted. No objective evidence of parasites was found and his infection resolved with antibacterial therapy (intravenous ceftriaxone and vancomycin, and topical vancomycin and ceftazidime). Delusions of parasitosis may result in self-mutilation with secondary infection. Appropriate psychiatric care is needed to prevent ongoing destructive behavior.

Language: en