Getting to the Bottom of What’s Bugging You: A Curious Case of Delusional Infestation

The week of Halloween, we evaluate a patient complaining of bugs crawling over her bed. Blinded from retinopathy, our patient calmly sits upright in the dark making quiet hums. You see her silhouette as she delicately plucks an insect off of her leg and crushes it between her thumb and index finger. Discarding one, only to be replaced by another. But when the lights turn on, no bug is in sight. We present a Case of delusional infestation in a nursing home patient with multiple medical and psychosocial comorbidities.