Delusional parasitosis

Cecil's Columns/Staff Reports
21

Just a quick reminder from the Moderator: this is not a group of doctors. Even if it were a group of doctors, no one would try to make an analysis from website photos. So, let’s not go leaping to medical diagnosis one way or the other.

We can agree that some people do have parasitic infestations. We can agree that some other people don’t, but think they do, and that this is delusional. Further than that – trying to determine what the situation is for any specific case – requires medical analysis. Photos taken with a Polaroid and put on a website are useless (yes, I’m exaggerating for the sake of emphasis) for medical diagnostic purposes: neither the photographer nor the medical specialists should pretend otherwise.

22

Let’s be clear here. My post did not represent a diagnosis of what is troubling the poster, but an observation that the objects portrayed on the website do not resemble parasites. It explicitly outlines the need for medical workup, and suggests that if that has been unproductive another type of treatment should be looked into.

No diagnosis was made, either of parasitosis or delusional parasitosis.

I don’t know about the “Polaroid” part of it, but photos placed on website are quite useful for diagnostic purposes. There are numerous good medical websites with photo libraries which I have found helpful in my field. If someone were to post decent quality photos of, say, a pinworm, then others would be able to identify it as such, while not being able to conclude that “Your child has pinworms”.
O.K.?

23

We know that, Dex, but nobody is making anything like formal diagnoses and we’re trying real hard to be gentle and understanding and openminded while dancing around the what most of us believe is the obvious diagnosis.

I was surprised to learn that some protozoa can be up to three or four MILLIMETERS long! (reading further) Oh, they’re probably talking about big amoebas or slime molds and the flagellated ones apparently max out at a tenth that or smaller. And live in much moister environments than your epidermis since flagella don’t do much good out of the water.

24

Ditto. I am not a doctor, neither do I play one on TV, but I do have a microscope (Two of them, in fact - one of which is exactly the same as the one owned by Ever Hopeful) and I have examined various bits of myself (such as skin flakes etc, fingernail clippings), bits that came off my kids (i.e. head lice and their eggs) as well as microorganisms (that I found in ponds and in the garden) with them.
I don’t see anything in the micrographs on Ever Hopeful’s site that looks like a parasite; I do see lots of things that look like mundane objects. Just observations, that’s all.

25

My “Polaroid” comment was to differentiate between a home-made shapshot and a carefully taken diagnostic tool. I agree, medical information provided online can be useful for diagnosis – but that’s when you’ve got a picture taken by a reputable laboratory, using standard equipment, and that’s why I used the term “Polaroid.” A home-made photo is far less reliable for on-line diagnosis, one way or t’other. Heck, I’ve seen online photos of people that I knew and I wasn’t sure it was them, so how would I identify a parasite or a dandruff flake?

And, agreed, the more we get into this, the more the info looks one-sided. I’m not really worried about folks like dropzone or Jackmanii or Mangetout et al , they’re not going to be confused about ad hoc opinions vs medical diagnosis. I was worried about others who might come to read these threads, who might not be so astute. Sorry if I was unclear.

26

Well, considering how the auto insurance industry uses Polaroid photos because they are so hard to retouch… But I think I know where you are going.

“(T)he more we get into this, the more the info looks one-sided.” Diplomacy like that is why you are a mod while I am trying to not let “mad as a March hare” sneak into my response.

Oooops. :frowning:

27

You know, I was racking my brains over the flip flop thing because I’m sure I’ve seen that repetitive pattern of rows of little circles before somewhere… then I realised… I’ve seen a pattern like that embossed on the rubber ‘thong’ parts of a pair of flip flops! - you can just about see something like it in here.

28

Purely for educational purposes (and not as a commentary on the prior poster) - here’s just one of a number of forums for people who obsess over their alleged parasites and how to eliminate them.

This website, in my humble opinion, is the most comprehensive collection of health looniness to be found online.
Enjoy. :rolleyes:

29

For the record, I was not the one who came up with the idea that a flagellate protozoa was involved. I had been thinking along completely different lines (helminths, in fact). That term came from scientists. It surprised me, but doing a little research, it begins to make a little bit of sense to me. One thing I have learned is that protozoa come in a range of sizes, including macroscopic:

http://medical.webends.com/kw/protozoa

Protozoa
Protozoans
A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: SARCOMASTIGOPHORA; Labyrinthomorpha, APICOMPLEXA; MICROSPORA; Ascetospora, Myxozoa, and CILIOPHORA

Similarly, the video has been carefully analyzed by scientists who find it likely that it really does depict an actual organism. All of the researchers, however, found it difficult to believe what they were seeing (they did test as thoroughly as they were capable of doing to make sure I hadn’t “tampered” with the video and were reasonably sure I hadn’t)–and equally difficult to make any kind of statement about what it actually shows. Their report will be published, but that will take a few months.

The rest is not worth arguing with you about. I agree with some of your statements–especially concerning the “grains of sand”–up to a point. However, in many cases you are seeing what you expect to see, not what is actually there–especially with some of the burrows and fibers photos. If these photos were presented to you (for some odd reason) by a qualified parasitologist and you were told that they contained evidence of a parasitic infection, you would see something different. But it’s no matter, really. Actual scientific researchers are working on this, and what they have found differs considerably from what you are seeing. However, your response is extremely typical and understandable. I would probably have had a similar opinion myself before this happened to me.

I don’t know what’s in my photos, of course, and hope that eventually research will discover what is causing my illness. The scientists working on this are underfunded (sometimes unfunded) and fighting an uphill battle. Nevertheless, they are making some progress. I suspect that within a decade we will have some answers.

I’m actually hoping a protozoa is not the culprit, since protozoan illnesses are notoriously difficult to treat. They generally become chronic, life-long conditions. I’d much rather have a bacteria or a helminth.

Whether or not my pictures are convincing to you and other board readers is really beside the point. My point is that that concept of delusional parasitosis deserves closer scrutiny, and the diagnosis itself is too casually applied–especially because these symptoms can signal some very serious underlying medical conditions. I have put out the following challenge before, and no one has yet met it: find me one carefully documented case of primary delusional parasitosis for which sensitive and precise testing for parasites has been done and turned up negative. Every case I’ve located has turned out to be secondary delusional parasitosis with some underlying physical or mental condition.

But received wisdom in medicine does not turn on a dime. Many, many major discoveries in the past several decades have started out as ideas that were ridiculed, ignored, and vituperized by the majority of medical researchers and practitioners. It sometimes seems that the most quickly accepted ideas are also the ones most quickly proven to be inaccurate. A recent study has shown that an enormous percentage of “exciting new breakthroughs” are eventually disproven by later evidence. It almost seems that the most unpopular theories that eventually do gain acceptance tend to hold up better over time–possibly because the level of proof to get them accepted is so much higher.

So it will take real dedication and time and effort and energy to find out what is causing this illness. Fortunately, the people who are working on this are very dedicated. They find it heartbreaking to see people so ill with no support from the medical community, and so they find ways to keep working without much support for themselves.

In the meantime, people are getting very sick. Whether my grains of sand are just sebum or the result of an immune response to a foreign body in my skin is not that important. What is important is that medical “science” needs to work from a basis of sound evidence, not from the repetition of an idea that has never been proven in the face of clear evidence that people are physically ill. I am not delusional. I do have a physical illness that can be very debilitating. And I should not be out here on my own trying to figure it out. The concept of delusional parasitosis is the reason we cannot get proper research and care. And so I do what I can to point out the problems with the theory. Focusing too much on what’s in my pictures misses my larger point. But if my pictures get people to read and think about, and perhaps reconsider, the diagnosis, then the pictures have accomplished something.

Thank you all for your comments.

30

Let me get this straight.

There are “scientists” who have seen your video and are currently gonna publish a paper on what they saw on your video? Is that correct?

Hogwash, Sir! Pure Bunkum!

You have been bamboozled by ersatz scientists.

31

So is your position that there is no such thing as delusional parasitosis, ie that it is never ever a correct diagnosis?

Or that because you believe it to be harmful to the resolution of your case, that it should never be considered in a diagnosis even if potentially a correct diagnosis?

32

Coming at this from a purely scientific approach, the null hypothesis is that these “delusions” are particles which are normally found on human bodies. Luckily, that is perfectly testable. Take the photos or (even better) the actual samples to a forensic scientist. They are experts at identifying this kind of stuff. If they can’t identify them, that adds support (note: not proof, but support) to your hypothesis that they are unknown parasites.

I’m a microbiologist. I don’t specialize in parasitology, but I’ve studied and worked with parasites. Nothing in your pictures looks like parasites to me. Currently, I study mechanisms of motility and your video clearly shows a non-motile particle. Truely motile organisms move with intent and quickly. The small movements in the video are attributable to currents, vibrations and Brownian motion. I see it all the time in my genetically non-motile strains.

That said, I really hope your find an answer to your problems, be it infectious of not. And I’ll be keeping an eye out for that paper…

33

I don’t believe a scientists would find that likely, but I’ve been wrong before; why don’t you post back when you have something concrete?

Deliciously ironic. Thanks

Many, many more of the things that were ridiculed or ignored were trated that way because they were worthless crackpottery; you’re half an inch away from the ‘Galileo’ argument here.

34

Well, you are asking me to demonstrate the “matchbox sign,” of course, which would prove that I am delusional. However, what you suggest has actually been done. The fibers are not from clothing, upholstry, carpeting, or any other type of fabric, fabricated, or manufactured material. I believe, and I would have to go back and check this, spectrometry shows them to be some type of cellulose.

I do not believe that the most of “fibers” are themselves parasites. I do believe that many are the result of a parasitic process.

Since you are a microbiologist, I wonder if you would take another look at the first blue fiber (on the left side of the screen) and tell me what you think that structre at the top looks like. Another photo that confuses me is on the same page, in the series of that shows the first red fiber, particularly what is depicted in the middle “close-up” that shows where the fibers appear to attach to the skin and the red stuff that appears to be inside the skin. I’d love your opinion of what it represents. Here’s a direct link to the fibers page: http://www.dpref.com/fibers.html

And finally, the last photo in the first series of “blood fibers” is of particular interest. Here’s the direct link to the page: http://www.dpref.com/blood.html

Thank you for your time and open mindedness.

Thank you for your input. In the five-minute video, which is actually part of a series that lasts over half an hour, the fiber does move quickly and with apparent intent. The PI of the current study (who has a copy of the recording) tends to agree with me, but is still baffled by what it might be. If motility is not clear in what you saw, it is probably due to the quality of the recording and/or playback. I am perfctly aware of how unconvincing this sounds. I am successful in locating similar samples a high percentage of the time and I wish someone with your expertise would watch with me and explain to me what is going on. Currents, vibrations and Brownian motion cannot account for everything I have witnessed.

Thank you. I will post when I learn the journal and date. In the meantime, there is an article already published in a peer-reviewed journal that has identified collembola in the skin of 18 of 20 subjects examined. It remains controversial, but it is interesting. The PI has passed on, to our sorrow, but the lead author continues to advocate for further work on our condition. Here is the link: http://www.headlice.org/report/research/jnyes.pdf

I personally do not think collembola will be found to be the ultimate cause of this condition, but I am grateful for any and all research being done and do believe this study marks an important step toward understanding this illness.

35

The most obvious and glaring defect in that article is that no one bothered to check whether Collembola were present in the skin of normal controls (i.e. as commensal organisms). Another is the apparent lack of recognition that in individuals who are scratching and excoriating their skin, secondary colonization or infection by bacteria, fungi or other organisms is possible. It doesn’t mean that they caused the symptoms in the first place.

It is also hard to believe that no pollen, fibers or other “unexpected” detritus was found on the skin of normal controls, unless they were living in a hermetically sealed bubble.

36

Umm…you mean like plant matter? Like, say cotton? Linen?

I haven’t looked at much of my skin under a microscope recently, but at 200x, I would like to think that you would notice major body structures of a parasite, like a mouth or an anus, or a motility structure. IIRC, and maybe Red Stilettos can confirm, you can clearly see flagella on bacteria at 200x. You should also be able to see a nucleus, were one present. I know that the eggs of intestinal parasites are easily recognized and identified as non-fecal material at 200x as that used to be part of my job. Even if you can’t identify it as a specific parasite, it still looks different from the normal background debris.

I’m with Jackmannii, show us that A) these items are not found on people without the symptoms of DP, and that B) Normal, daily actions like scratching, washing, etc. are taken into account.

Also, your argument that nobody with DP has not had a past ‘oogy bug’ experience does not convince me, since I do not know of anyone who has never has a psychologically negative interaction with an insect, parasite, or microbe. So far this summer, I have seen, on my person, mosquitos, biting flies, a leach, a cockroach, and a tick. I have also captured and/or killed several spiders, silverfish, mealworms, another cockroach, and some unidentified gnats. We encounter insects from birth, so it is only logical that someone with DP would recall a past bad experience with bugs or parasites and that the more intimate the infestation, the more disturbing it would be.

37

From this site: “There are no parasitic springtails (Collembola) of any sort, and the few examples of them infesting humans have been due to very peculiar circumstances. One of the most remarkable ones was a man who, collecting Collembola extensively in the Arctic with a leaky aspirator, manages to get a culture living in his nasal passages! He discovered this when Collembola started showing up on his handkerchief after he blew his nose. Other people who work around horses occasionally find Collembola living in their hair, but there have been few reports of this in recent years.”
The author of this piece, Kenneth Christiansen, is one of the world’s authorities on Collembola (he was a professor of mine years back). If Ever Hopeful wants to track the Collembola Connection further, he can probably contact Dr. Christiansen through Grinnell College (he is semi-retired but still interested in springtails).

38

I would be more interested in seeing this report than anything from a parasitologist right now. Occam’s razor says that these are not the result of an infestation. The evidence (or at least the scientific opinion) is so strong in that direction, that it has to be addressed fully. Otherwise, you will never get the acknowledgement that you want and need to move on.

None of these photos show anything I could identify by name. Many of them look like general slide/sample contamination. Slides straight out of the box are extremely dusty. It’s easy to find dust and fibers like you see on brand new slides. I don’t know that that’s what’s going on; it’s just a thought.

As for the blood fibers, I highly doubt that the fibers are actually in your bloodstream. If the blood came from skin lesions, it’s likely a contaminant from the skin surface. Also, a drop of blood left to dry will pick up household dust. Those pictures are not convincing to me in any way.

Currents, vibrations and Brownian motion can account for a lot at a microscopic level. Remember how small these particles are; it doesn’t take much to move them. True microscopic motility looks very different. Take a look at some of the movies on this site to get a feel for the difference. Even when microbes are artificially tethered to a surface their movement looks different from your video.

Plus, the “flagellum” doesn’t look right. It’s much too irregular. Flagella are (relatively) massive structures with hundreds or thousands of repeats of the same protein. Thus, they are very regular and smooth in their appearance.

I agree with Jackmannii. The authors admit to not analyzing the controls in as much detail as they did the symptomatics. The paper is deeply flawed.

I am not an entymologist, but the pictures are not convincing to me. We are in the age of molecular biology and DNA. If they think Collembola (or any other organism) is present, show me the DNA and prove it. The methods are easy and available.

39

Not necessarily. Bacterial flagella are so thin that they tend to disappear in the glare of a light microscope. You have to stain them to see them in a light microscope (actually it precipitates the stain along the surface, thickening them up). However, parasites tend to have much larger structures that will be visible at that mag. Jackmannii would probably be better able to address the visibility of those critters.

40

I stand corrected, we must have stained them to look at them. I used to know like 30 ways to stain a microbe, but I forgot most of them as I was walking out of the exam room.