Thank you very much. Your input is very interesting, and I truly appreciate your scientific opinion and, of course, your time.
In fact, all of the replies on this thread have been very interesting to me. I never would have expected such a response from people who apparently have no personal stake in this issue. Fascinating. And, I believe, very useful for me to understand. I will update as research progresses. Thank you all.
Red Stilettos, I am trying to educate myself as to what I should be looking for in my (or anyone’s) photos. I have been looking at pictures of genuine parasites on the web. I am not trying to challenge you or anyone, just sincerely wanting to learn how to train my eye to see what you see. I wonder if you can explain to me the structures that are visible to someone with your training and experience that identify the parasites in either or both of these two pictures (but which are not present in my own pix):
Thank you again. I’m sorry to be such a nuisance. Probably I should go back and study microbiology myself if I really want to answer these questions. But in the meantime, I’d be very grateful for your instruction. EH
I scratched my back a moment ago and there was a little sand-like grain on my skin - these are the remains of little pimples that never amount to much, then dry up by themselves and are expelled as little hardened lumps of debris; I examined it under my microscope and look (60x magnification), it has a pair of little hairs sticking out of it.
I opened the first aid kit and pulled off a little tuft of sterile cotton, despite my every effort to sit completely still and refrain from any action that might cause movement., it moves about, all on its own (200x magnification) when viewed under the microscope.
The IntelPlay computer microscope is a toy - a damn fine one, but it has a number of failings, including;
-It is prone to ‘image crawl’ - it’s just a glorified webcam really, and compression artifacts and random pixel failts typically make even static objects appear to pulse with life.
-It is prone to vibration and thermal movement from the warmth of the electronic components.
The illumination is done by cheap incandescent sources - these warm the subject; in the case of natural materials such as plant fibres, this will drive off moisture and cause movement.
Mangetout, you are the best. Thanks so much for actually taking the time to do a little looking on your own, offer an honest opinion, and explain a little science to me.
I think I actually see a single hair lying across your grain of sand, but I’m not willing to bet anything on it–the pic is just not clear enough for me to tell. Otherwise no argument on that one.
Your “moving fibers” thing is so different from mine, that it doesn’t seem nearly as relevant. I have seen the kind of motion your clip demonstrates many times, but what I saw in the clip I posted was a lot different. How much of my video have you actually been able to view? I know it doesn’t always play so well from the site.
Your posts are completely straightforward, deal directly with the subject at hand (although you have chosen the photos rather than the concept to address), and you work towards as much rationality as possible. And I really appreciate it. I wonder what you make of two of the fiber photos I mentioned in my earlier post–the middle close-up of the red fiber, and the structure at the top of the first blue fiber (on the left side of the page)? Thanks again.
In both of these pictures, there are definite differences between the parasite and the surrounding debris. In these cases they are both darker. Both of the parasites have visable internal structures. I have seen neither charachteristic in your pictures. The big disclaimer in that is that neither the set of pictures on your website nor the two pictures you posted are very informative. I find it suspicious that you have all these ‘delusions’ you ‘found’ on you skin, yet I only see pictures of skin flakes with normal skin structures and pictures of random things that don’t seem to be affiliated with any skin cells. Have you done or had done any scrapings? Can you show us that? One of the hallmarks of parisitism is that it is within the tissue, not just transiently associated with it. Can you show us an organism with internal structures that would indicate that it is some sort of lifeform?
here are some nice pictures of the same parasites along with symptoms of descriptions and even some pictures of the lesions the cause. Which brings up another interesting point…what are the symptoms these ‘delusions’ cause? How do you know where to find them? Are they localized or dispersed?
Are those genuine parasites not stained?
[QUOTE]
Both of the parasites have visable internal structures. I have seen neither charachteristic in your pictures. [/QUTOE]
Can you point me to those in the second picture?
Okay, I understand your suspicion. This is difficult to explain; it would be much easier if you could watch the process. The dark fibers and specks are apparently under the skin. If I apply hydrogen peroxide to my hands, for instance, I can watch them pop up out of my skin. And, no, they are not in the peroxide to start. (In 2001, they were also visibly present in some nasty lesions on my forearm that resulted from a rash that itched enough to wake me up at night.)
I have certainly done scrapings–I’m not sure what you’re looking for. If you give me more details, I will see what I can do. BTW, when that rash was treated in 2001, two different doctors diagnosed scabies. They did so without any scrapings. The first told me he could never find a scabie even when he did do scrapings (not just on me, on anyone)–he wasn’t a good enough scraper and/or microscopist to know how to find them. The second did not do a scraping because the empirical diagnosis of scabies was clear to him from the way the rash had responded to the prescribed pesticide (permethrin) treatment. It went away–almost. He had me use permethrin repeatedly. It was only after the rash continued to return about a week after each treatment that he began to wonder if it really was scabies. My blood work at the time I began those permethrin treatments was abnormal and showed high levels of the antibodies (or whatever–some kind of white blood cells) typical in a scabies infection. Only when the permethrin treatments eventually failed to clear this infection completely did this dermatologist begin to think I was delusional. Until then, the rash, bloodwork, lesions, etc., were all consistent with his diagnosis. However, scabies should go away and since it continued to return (although with much decreased severity) it could not be scabies. And since there are no other skin parasites, I must be delusional, especially since it was about this time that I experienced the sensations of something crawling on my skin and started looking at my skin myself (he still would not do a scraping). This is the reasoning I was presented with.
[QUOTE]
One of the hallmarks of parisitism is that it is within the tissue, not just transiently associated with it. Can you show us an organism with internal structures that would indicate that it is some sort of lifeform?
I am very familiar with those pictures, but thank you for the tip.
My medical history is too extensive to present here–and I’m not sure I’d want to anyway. In 1988 I was diagnosed with a rare skin disorder, Pityriasis Lichenoids et Varioliforma Acuta (PLEVA) on the basis of clinical observation of the thirty or more unexplainable lesions on my legs and associated secondary bacterial infection invading the lymph channels around the lesions. Punch biopsy was consistent with PLEVA. PLEVA has an unknown etiology but has been associated with toxoplasmosis infections (a fact I only recently learned). I was treated with erythromycin for the secondary infection. The PLEVA became chronic, but much less severe, after that. Since then I have had a number of other health problems that leads me to suspect that this illness is dispersed and multi-systemic. I have had suspicious “spots” removed from several places (not at my request, at a doctor’s insistence), including one from under my tongue. Biopsies generally return negative results, although some have been identified as “pre-cancerous.” Once removed, none has returned in the same place, at least not yet.
I have had serious outbreaks on my arms, legs, and face, with painful lesions that persist for weeks and sometimes months. Since the rash in 2001, these have been non-itchy. The one on my face was diagnosed as a staph infection, although the culture for bacteria came back negative. I had not been in the hospital at that time.
I do not always know where to find my delusions, especially when lesions are not present. And I don’t spend much time looking for them anymore. This illness follows a relapsing/remitting pattern, and during bad cycles I can sometimes feel the crawling sensations, especially on my face. I am currently lesion free, however the skin on my abdomen is peeling and scaly, and the diagnosed “fungal infection” of my toes (again culture returned negative) never goes away even with treatment with oral anti-fungals. Symptoms of internal infection are worse. And, no, I will not be more specific on this board.
Please note that every doctor I have seen has taken my symptoms seriously, sometimes more seriously than I have, with the single exception of crawling sensations, which I have been told absolutely must be imaginary, even if they occur just prior to lesions appearing. Doctors and dentists have insisted on surgically removing some of my spots and lumps, warning me of potentially life-threatening cancer if I do not have the surgeries. (Naturally, I have taken their advice.) The main reasons a doctor began to suspect I was delusional was because, (1) after about 8 rounds of permethrin prescribed by him, I still had lesions and began to experience crawling sensations, and (2) in the face of his inability to diagnose me correctly and treat my lesions, I began looking at my skin myself (the matchbox sign). I should mention that “delusional” has never been formally entered into my medical records. However, I know better now than to ever mention “crawling sensations” or “parasites” to a doctor. I am perfectly sane, intelligent, hold advanced degrees and a full-time job, maintain a busy social and family life, have many outside interests and engage in them to the extent my illness allows me to. Neither you nor anybody else would ever suspect me of a mental illness if you knew me, unless I said the word “parasite.” But the belief in the possibility of an unknown parasitic infection being responsible for persistent otherwise undiagnosable symptoms is diagnostic of mental illness. And the desire for further research to be done on my illness confirms the seriousness of my mental illness. Go figure. Sorry to rant, but you asked.
I am not a parasitologist, nor am I a pathologist, so I am not the best person to expain these pics. xBuckeye and Jackmannii are much more qualified than I.
My issue is with the burden of proof. As you know, it’s very high for you. Whether it should be or not, I’m not going to debate here. Isolation and microscopic identification without staining is the least reliable method of ID. Generally, this is only acceptable when the symptoms are quite clear and the ID makes perfect sense. You do not have that situation, so you must go further.
There are plenty of ways to confirm an infestation. Using DNA techniques seems the most conclusive to me. PCR can be sensitive enough to detect one bug. You can also do in situ hybridization which is a way of “staining” the DNA of the organism while it’s in the sample. They could prove that those are Collembolas in the pictures in the article. The catch with DNA techniques is that you need to know what you are looking for.
Another option is stains. Again, IANAparasitologist, but I would imagine that there are ways to stain parasites that separates them from surrounding tissues. Perhaps, something that stains the exoskeleton or cell wall?
It’s also worth mentioning that proof of etiology generally follows Koch’s postulates. 1) Organism is present in all cases. 2) Inoculation of organism into healthy subject reproduces the same symptomology. 3) The organism can be isolated from the experimentally inoculated organism. I know some of these will be hard to do in your case, but this is the gold standard for microbiology. Ultimately, they will have to be addressed for the scientific community to accept the diagnosis.
There’s good information on this site about the nature of delusional parasitosis, the wide variation in the types of patients it afflicts, and the workup necessary to exclude organic causes of the symptoms.
More here as well.
And here you have absolutely hit the nail on the head. (BTW, as I have previously posted, I do not believe collembola will prove to be the ultimate problem here. I do hope further research is done along these lines, and, as you say, it should be fairly easy to confirm, but research costs money and at the moment, with the PI deceased, no one wants to do it.)
If, however, this organism is truly something unidentified, there is no DNA available for comparison purposes.
Again, no one is interested in doing this.
I have recently read that Koch’s postulates, while the standard for microbiology, would virtually dismiss all vector-borne parasitic illnesses, because these cannot be reproduced by innoculating healthy subjects with the organism. Catch 22 for us. I will look for the citation. I think it is either something by Daniel Brooks (a world-renowned parasitologist) or Carl Zimmer’s book, Parasite Rex.
I include both sites on the page of references on my website and both are cited in my piece on the concept and science of DOP. Have you read that piece?
Forgot my thanks. I so much appreciate your taking the time to respond.
The citation is from Carl Zimmer’s <i>Parasite Rex</i> (New York: The Free Press, 2000):
"Medical schools focused their students on infectious diseases, and generally on those caused by bacteria (and later, by the much small viruses). Part of their biases had to do with how scientists recognize causes of diseases. They generally follow a set of rules proposed by the German scientist Robert Koch. . . Bacteria fit these rules without much trouble. But there were many other parasites that didn’t. . . " (p. 11)
“. . . there are thousands of species of parasitic protozoa, and they include some of the most vicious parasites of all.” [Describes plasmodium, which causes malaria, and trypanosomes, which cause sleeping sickness.] “Yet despite their power to cause disease, most protozoa couldn’t live up to Koch’s rigorous demands.” (p. 12) And then he goes on to explain why.
As I say, bad news for us.
Yes. It contains false comparisons, speculative irrelevancies and is based in part on strawmen (such as the assertion that physicians don’t believe in parasites other than scabies).
But I posted those links not in an attempt to sway you, but as a resource for others who are reading this thread who might like a balanced medical overview on diagnosing this condition.
For the record, the UC Davis site is not a medical site, but an entomological one. The only parasites it describes are arthropods. It makes no mention or protozoa or helminths, including, for example, either leishmaniasis or onchocerciasis, both of which are parasitic illnesses known to cause skin lesions.
It is also somewhat misleading even with respect to insects:
“Very few different kinds of insects are parasitic on humans, and most of these are biting flies. All of these insects feed on blood. However, only two kinds will remain on the skin or in clothing for any length of time. These are the lice and fleas.”
Botfly myiasis is caused by neither lice nor fleas, and the larvae can and do remain in (admittedly not on) the skin and tissue below for a length of time. I cite an article in the Washington Post (which is no longer available online, unfortunately) describing a woman who acquired this parasite in Costa Rica and the response of the dermatologist she consulted, who pointed to his head indicating he thought she was crazy.
The article on Medscape, which I cite(http://www.medscape.com/viewarticle/410144_1), makes this statement:
“Many physicians who have not themselves encountered myiasis may dismiss a patient’s complaints or attribute them to an insect bite that will heal without treatment.”
The UC Davis site is often cited and considered to be an excellent resource. But a careful reading of its information confirms my general thesis that there is little awareness in the United States of parasitic illnesses that can cause skin symptoms.
Actually, I believe that Occam’s razor works for my thesis. Bacterial infections for which the bacterial culture proves negative, fungal infections for which the fungal culture proves negative, scabies infection that fails to respond appropriately to scabies treatment, rare skin disease of unknown etiology, bloodwork showing white blood cell levels consistent with a parasitic infection, and at least four other significant unexplainable physical symptoms, witnessed by medical professionals (I am particularly amused when they say, “Oh, my god! I wonder what caused that!” or something similar), which could all be explained with a single explanation.
Perhaps this is because the site concentrates on the syndrome of delusional parasitosis and covers insects likely to cause actual problems, rather than going into exhaustive detail on all sorts of parasites that afflict humans in various parts of the world.
For instance, myiasis is a problem in parts of Central and South America and Africa. If someone from America or Europe has not traveled there, it is not a diagnostic consideration. Similarly, onchocerciasis or cutaneous leishmaniasis are not considerations for Americans with weird skin-related symptomatology who haven’t traveled (there are rare exceptions for cutaneous leishmaniasis, such as a very few people living in rural south Texas according to the CDC).
If one is a world traveler and the examining physician does not get the history, an exotic infection can occasionally be missed. If one has not been to an endemic area, it is not make sense to conjure up such possibilities.
The UC Davis site is published on the World Wide Web, not the North American Web. I have seen it referenced in articles written by writers working in Africa and Asia. It has other omissions and errors that I did not mention (demodex, for instance). It should be more precise in its language. It would not be that difficult.
The woman with the botfly myiasis reported her visit to Costa Rica to the dermatologist who nevertheless dismissed her reported symptoms in favor of DOP.
If one has suffered from otherwise unexplainable, documented symptoms for 17 years, it does make sense to consider previously unidentified possible etiologies, including unknown organisms, organisms not previously thought to be pathogenic (like toxoplasmosis which has recently been implicated in brain changes), and organisms transplanted by modern transportation methods from “exotic” locations to this continent (like the West Nile virus, now endemic throughout much of the country). To resort instead to an unlikely mental illness for which almost no clinical support exists is both irrational and irresponsible, especially in the absence of appropriate testing.
I think you may be right - it may be a single hair or fibre.
I downloaded your video and played it from my local hard drive; there are differences, yes, but I don’t think they’re particularly significant differences; If I’d been presented with your vide completely devoid of context, I’d have interpreted it like this:
The moving fibre extends off the bottom of the screen - it is pivoting on some object not visible and extends beyond that object; the visible part is set away from the microscope slide a little, then it curves downward and is attached to a small flake of debris that is almost in contact with the slide.
The free end (the one we can’t see) of the fibre is beiong perturbed by subtle air currents, causing the visible end to twist back and forth on the pivot; as this happens, the flake of debris eventually runs aground on the slide. The fibre continues to flex and twist on the pivot under the influence of air currents.
I believe the microscope software may have dropped a couple of frames while recording, making some of the movements appear more jerky that they would otherwise.
Thank you; I’m trying my best. I think it’s only fair to admit that I’m struggling; your website just comes across as being the work of a person suffering delusions. Sorry, but it really does - this isn’t meant as an insult.
I think probably the reason for this is not only the rather vague nature of much of the evidence presented, but also the number and wide variety of symptoms you say you’re suffering; it just seems too fantastic that all of these different things could be happening to a single person and that the medical profession wouldn’t sit up and take notice of at least one of them.
All the implied picking and gouging is a bit of a concern too; I mean, I don’t have abnormal fibres in my blood, but my blood doesn’t just pop out on its own for examination.
I gather from this that you do not have a travel history to support raising exotic possibilities like botfly infestation and onchocerciasis, which are not endemic here.
When one has eliminated other possibilities through exhaustive medical evaluation, seen typical behaviors through repeated clinical observation, and documented remission of symptoms in many cases through administration of antipsychotic medications, it becomes a reasonable medical diagnosis. Bizarre, yes - but no more so than other psychiatric disorders in otherwise well-functioning individuals, such as Munchhausen’s syndrome and Munchausen’s syndrome by proxy (the latter abundantly documented through means such as video surveillance, but which has spawned furious denial and even legal practices devoted to exonerating patients charged with harming children).
A couple of other points - there are a number of skin disorders which have psychiatric components to one degree or another, including trichotillomania and lichen simplex chronicus. These may be difficult to diagnose, and psychiatric intervention may be curative.
Undergoing a large number of medical tests and procedures, regardless of whether there is true underlying disease, increases the likelihood that one or more will generate abnormal results, leading to more procedures and possibly more inaccurate results. The patient thus builds up a file of “documented” abnormalities and a history which can be refuted only by patient, skilled workup.
If physicians were totally unaware of the possibility of unusual and exotic infections (including parasitism), I would not be seeing so many requests for laboratory and surgical pathology evaluation to explore the possibility of such conditions. As just one example, I typically see several requests per week in patients with gastrointestinal symptoms to rule out Giardia, a water-borne protozoan parasite.
“…organisms not previously thought to be pathogenic (like toxoplasmosis which has recently been implicated in brain changes.”
I meant to comment on the inaccuracy of this claim. Toxoplasmosis has been known to be pathogenic for a very long time, and its capacity to cause central nervous system disease is also nothing new.
