Urethral stricture secondary to self-instrumentation due to delusional parasitosis: a case report

Hdl Handle:
http://hdl.handle.net/10147/577395
Title:
Urethral stricture secondary to self-instrumentation due to delusional parasitosis: a case report
Authors:
Ismail, Muhammad F; Cassidy, Eugene M
Citation:
Journal of Medical Case Reports. 2015 Sep 15;9(1):197
Issue Date:
15-Sep-2015
URI:
http://dx.doi.org/10.1186/s13256-015-0686-5; http://hdl.handle.net/10147/577395
Abstract:
Abstract Introduction Delusional parasitosis is a rare psychiatric disorder which often presents with dermatological problems. Delusional parasitosis, which involves urethral self-instrumentation and foreign body insertion, is exceptionally rare. This is the first case report to date that provides a detailed presentation of the urological manifestation of delusional parasitosis with complications associated with repeated self-instrumentation and foreign body insertion, resulting in stricture formation and requiring perineal urethrostomy. Case presentation A 45-year-old Irish man was electively admitted for perineal urethrostomy with chronic symptoms of dysuria, haematuria, urethral discharge, and intermittent urinary retention. He reported a 4-year history of intermittent pain, pin-prick biting sensations, and burrowing sensations, and held the belief that his urethra was infested with ticks. He also reported a 2-year history of daily self-instrumentation, mainly injecting an antiseptic using a syringe in an attempt to eliminate the ticks. He was found to have urethral strictures secondary to repeated self-instrumentation. A foreign body was found in his urethra and was removed via cystoscopy. On psychiatric assessment, he displayed a fixed delusion of tick infestation and threatened to surgically remove the tick himself if no intervention was performed. The surgery was postponed due his mental state and he was started on risperidone; he was later transferred to an acute in-patient psychiatric unit. Following a 3-week admission, he reported improvement in his thoughts and distress. Conclusions Delusional parasitosis is a rare psychiatric disorder. Self-inflicted urethral foreign bodies in males are rare and have high comorbidity with psychiatric disorders; hence, these patients have a low threshold for referral for psychiatric assessment. The mainstay treatment for delusional parasitosis is second-generation antipsychotic drugs.
Language:
en
Keywords:
MENTAL ILLNESS; URINARY TRACT DISEASE; PSYCHOSIS

Full metadata record

DC FieldValue Language
dc.contributor.authorIsmail, Muhammad Fen
dc.contributor.authorCassidy, Eugene Men
dc.date.accessioned2015-09-16T10:53:07Zen
dc.date.available2015-09-16T10:53:07Zen
dc.date.issued2015-09-15en
dc.identifier.citationJournal of Medical Case Reports. 2015 Sep 15;9(1):197en
dc.identifier.urihttp://dx.doi.org/10.1186/s13256-015-0686-5en
dc.identifier.urihttp://hdl.handle.net/10147/577395en
dc.description.abstractAbstract Introduction Delusional parasitosis is a rare psychiatric disorder which often presents with dermatological problems. Delusional parasitosis, which involves urethral self-instrumentation and foreign body insertion, is exceptionally rare. This is the first case report to date that provides a detailed presentation of the urological manifestation of delusional parasitosis with complications associated with repeated self-instrumentation and foreign body insertion, resulting in stricture formation and requiring perineal urethrostomy. Case presentation A 45-year-old Irish man was electively admitted for perineal urethrostomy with chronic symptoms of dysuria, haematuria, urethral discharge, and intermittent urinary retention. He reported a 4-year history of intermittent pain, pin-prick biting sensations, and burrowing sensations, and held the belief that his urethra was infested with ticks. He also reported a 2-year history of daily self-instrumentation, mainly injecting an antiseptic using a syringe in an attempt to eliminate the ticks. He was found to have urethral strictures secondary to repeated self-instrumentation. A foreign body was found in his urethra and was removed via cystoscopy. On psychiatric assessment, he displayed a fixed delusion of tick infestation and threatened to surgically remove the tick himself if no intervention was performed. The surgery was postponed due his mental state and he was started on risperidone; he was later transferred to an acute in-patient psychiatric unit. Following a 3-week admission, he reported improvement in his thoughts and distress. Conclusions Delusional parasitosis is a rare psychiatric disorder. Self-inflicted urethral foreign bodies in males are rare and have high comorbidity with psychiatric disorders; hence, these patients have a low threshold for referral for psychiatric assessment. The mainstay treatment for delusional parasitosis is second-generation antipsychotic drugs.en
dc.language.isoenen
dc.subjectMENTAL ILLNESSen
dc.subjectURINARY TRACT DISEASEen
dc.subjectPSYCHOSISen
dc.titleUrethral stricture secondary to self-instrumentation due to delusional parasitosis: a case reporten
dc.language.rfc3066enen
dc.rights.holderIsmail and Cassidy.en
dc.date.updated2015-09-15T06:01:49Zen
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