{GRAPHIC} Delusional Infestation in a Male With a History of Polysubstance Use

[smfadmin (OP)]

WARNING: GRAPHIC MATERIAL UNDER THE SPOILER !

Secondary Delusional Infestation in a Male With a History of Polysubstance Use

https://www.psychiatrist.com/pcc/secondary-delusional-infestation-male-history-polysubstance-use/?utm_source=Klaviyo&utm_medium=email&utm_campaign=news_wmr&_kx=va3uRF3O8-7Dg_zjrKMZJk0wdery-TOTVyZ3l8muM1g.VpkqxC

April 22, 2025

Delusional infestation (DI) is a psychiatric disorder characterized by self-induced cutaneous lesions. Patients maintain a persistent delusional belief that their body, particularly the skin, is infested with small pathogens, either living or non-living, despite a lack of dermatological or microbiological evidence.1–4 DI can present in various clinical forms, as classified by Le and Gonski5 and Hinkle.6 Table 1 outlines the 3 clinical subtypes of DI.


secondary-delusional-infestation-male-polysubstance-Use-24cr03887-t1.png (12.98 kB . 696x334 - viewed 66 times)

We present a case of secondary (organic) DI in a patient with a history of polysubstance use, including Δ9- tetrahydrocannabinol (THC), cocaine, lysergic acid diethylamide (LSD), 3,4- methylenedioxymethamphetamine (MDMA), phencyclidine (PCP), adrenochrome^Wiki (ed: fuck that's heavy, a scary Psychomimetic^Wiki), and ethanol. The patient sought emergency care for a severe cutaneous lesion in the left scapular region.

Case Report:

A 20-year-old man with a 5-year history of polysubstance use (THC, cocaine, LSD, MDMA, PCP, adrenochrome The theories commonly state that a cabal of Satanists rape and murder children, and harvest adrenochrome from their victims' blood as a drug[24][25] or as an elixir of youth.[26] In reality, adrenochrome has been produced by organic synthesis since at least 1952,[5][27] is synthesized by biotechnology companies for research purposes, and has no medical or recreational uses.[28], and alcohol) presented to the emergency department in August 2024 with a severe pruritic lesion in the left scapular region. Examination revealed a well demarcated ulcerated lesion with a perilesional erythematous halo measuring 30 × 30 cm, caused by excessive scratching (Figure 1). Over the past 22 days, the patient had been compulsively scratching due to delusions of “bugs eating his skin,” which led to self-inflicted injuries, and he occasionally ingested the scabs.

Spoiler: show

secondary-delusional-infestation-male-polysubstance-Use-24cr03887-f1.png (132.9 kB . 718x703 - viewed 67 times)

The patient had no prior history of mental disorders. He was admitted with a diagnosis of secondary (organic) DI and was treated with olanzapine 20 mg/d. A urine toxicology screen was positive for THC and benzodiazepines. The patient exhibited severe benzodiazepine withdrawal symptoms (Clinical Institute Withdrawal Assessment Scale-Benzodiazepines8 score: 40), and diazepam 10 mg was administered until the withdrawal symptoms were controlled.

Daily wound care with silver sulfadiazine, vitamin A, and lidocaine cream was provided as recommended by plastic surgery and dermatology consultation, with no antibiotics required per internal medicine. After detoxification and resolution of his psychotic symptoms, the patient no longer believed that he was infested with parasites and was transferred to a rehabilitation center for further care.

Discussion:

DI is a complex psychiatric and dermatological disorder characterized by challenges in both diagnosis and treatment. It can present as a primary somatic-type delusional disorder or secondary to other psychiatric conditions, medical diseases, or substance abuse. The disorder typically progresses from a cutaneous sensory misinterpretation to tactile hallucinations, eventually solidifying into a fixed delusional belief. In cases of substance-induced DI, the abrupt onset and transient nature of symptoms—lasting hours, days, or weeks—complicates the clinical picture.9–12

This case underscores the importance of close collaboration between dermatologists and psychiatrists for accurate diagnosis and timely psychodermatologic intervention. Atypical antipsychotics, such as risperidone and olanzapine, are considered first-line treatments,13–16 particularly because of their ability to reduce dopamine levels in the striatum, which is believed to sustain the delusional state.17 In secondary DI, treatment should address any underlying comorbidities. Prognosis largely depends on the promptness of diagnosis and the initiation of appropriate interventions, with good outcomes observed in most cases when treated early.18 Addressing both substance use and psychotic symptoms is crucial for improving patient outcomes, especially in cases in which symptoms may become chronic, makingmanagement more challenging and potentially leading to treatment resistance.

[Mr.pooper]

Time for a horrific story by mr.pooper…i caution anyone who reads this, it is a horror filled masterpiece sneak peak at my biography that i will eventually complete.

For 5 years i struggled with chronic open wounds on my legs. It started with a few cuts from skateboarding on my legs. A common injury when doing flip tricks is the board spinning, and hitting the ankles, and side of the shins. When messing up flip tricks, it will usually cause bruising and small lesions to form from the impact of the board. I had 4-5 small cuts in various spots below my knee. One day at the gym i slipped in the sauna stepping up the wooden 3 level bench seating. And hit my shin below the knee kind of hard. Didn’t think anything of it as I’m desensitized to such injuries from years of skateboarding. About a week later i noticed my pants leg was really wet. Upon taking off my pants and inspecting the cause. I noticed the spot in which i fell on in the suana created a wound that had become infected and leaking discharge pus. The discharge went down my leg and turned the “good skin” to a connecting wound. It connected all those 4 previous wounds into one long “connect the dots” type wound down my entire leg. Making a giant wound from my knee to my ankles.

I was using heroin and smoking crack heavily at this time. I had a domeless titanium nail on a bong hooked up the an electronic e-nail heating coil that i plugged into the wall socket. Thus having a perfect temperature heated titanium “dabbing nail” to dab heroin and crack together. I was buying heroin by the ounce. And also buying 1-8 ounces of powder coke at a time. And then cooking the coke into crack. I was not uncommon to smoke 7gs of crack a day side by side with globes of heroin off the e-nail bong.

This caused my wounds to constantly “leak”. Making the surrounding skin of the wounds constantly expand. I ignorantly ignored it, thinking it would just solve itself. It didnt. I would notice my pant legs get soaking went eberyday and leak into my shoes onto my feet. The wounds wrapped around my entire leg. And eventually spread to the other leg and created wounds from the knee down to my feet. And they leaked nonstop. I eventually had to start bandaging both of my legs entirely. The bandages would soil after a day, and soak my pants and socks. It cost me $500 in wound care supplies every week for 6x6 foam pads, and stacked 2-4 6x6 inch gauze pads on top of each foam pad. I would use 6 foam pads to cover my entire leg from the knee down. Then 15-20 gauze pads on top of that. Wrapped all in gauze roll, and then used the brown self adhering bandage tape to hold it all in place. On both legs. Wrapped from my knee to the ankles. It would soak through to my pants and socks everyday if i didnt change them. And it had a distinctive smell of rotting flesh after about a year of this. People could smell it out in the streets. And would verbally comment on the smell and i would deny it. Due to people treating the people with open wounds like leparasy diseased people, and wouldn’t associate with them. It was common word that we were contagious, and continued contact would cause the wounds to spread to others like a disease. When in reality the drugs are just being excreted through the skin to escape the body. Causing open wounds that dont heal, and leak constantly.

Fast forward 2 years later during covid, i could no longer afford the bandages, and couldn’t change them as frequently as i should have. One day i was checking underneath the bandages on my legs to see how badly they were leaking. Upon lifting the bandages it usually would be slimy, and as you pull up the bandages it would be this stringy slime. Well on this particular day as i lifted the bandages, to my absolute horror, the slimy strings started wiggling. I ripped off the bandages to discover my leg covered in maggots. I immediately jumped in the shower to frantically rinse them off, and dumped an entire bottle of hydrogen peroxide mixed with iodine all over my legs. Which slowly drew out the remaining maggots, and killed them as i soaked them over the next hour.

Now aware of the possibility that house flies could land, and lay eggs on my rotting wounds, brought a new horror surprise possibility, every time i checked/changed my bandages.

Fast forward another year. Im homeless in San Francisco strung out on fent. I caught something called “chingala sickness” caused by a highly contagious bacteria shigellosis. It causes severe diarrhea, and abdominal cramping. You lose all control of your bowel movements. I proceeded to accidentally shit my pants with explosive diarrhea that leaked down and covered my legs. I did not have any change of clothes, and no bandages to change my old ones. So i had to go about two days before i was able to go into a target, and get a new outfit, and some bandages, and wipes. I went to a bart train station bathroom, and locked the doors, and proceeded to cut off my pants and the bandages. My wounds were black scabbed and covered in fecal. As i cut off the bandages the outer layers cut off, but the ones directly on my skin were stuck to the wounds. From a mixture of the wounds, and fluids, and dried shit. I had to rip them off my legs and it caused them to start bleeding profusely all over the floor. As i was doing this, maggots that were huge, and obviously been there for days eating rotting flesh, amd growing to mature size, were slithering all over my legs, and open wounds. I started scraping them off my leg by the mini handful, throwing them onto the floor. By this time the blood had pooled around me a few feet. And the maggots were crawling through the blood, and crawling and trailing blood tracks like a slug across the floor and up the walls. Then someone knocked on the door. A station attendant, saying i had been in the bathroom too long and was going to open the door if i didnt come out immediately.

There i am standing in a pool of blood, half naked, with dozens of maggots crawling across the floor, and up the walls trailing the blood. With a pile of bloody puss covered bandages, and my cut pants on the floor. And bloody shit wipes from trying to clean off my legs. With maggots all over everything. With someone knocking on the door demanding me to come out.

I quickly stepped tip toed onto my boots, bleeding profusely into them to stop more blood from leaking onto the ground. grabbed the bandages i had, and wrapped my legs fast as possible. While grabbing out the remaining leg maggots and squishing them.(they pop
like squeezing a gusher fruit snack)Took off my boxers. And put on the pants i had. And halfway was standing tip toed in my boots. Then proceeded to try to soak up, and clean up the pool of blood with my cut jeans, and boxers, along with the bandages i had cut off, and the wrappers from the new bandages. Mopped up all the blood. And then started crushing, and squishing all the maggots with my hands still crawling on the floors, and walls. I managed to soak up all the blood, squished all the maggots, and wadded up and threw away everything in the bathroom trash can.

Now loud banging on the door, and multiple voices saying i have 30 seconds before they open the door. Looking down i had a small pool of blood in my boots from standing in them while trying to stay off the floor and clean. Shoved my foot in the boots, and the blood came up over the sides, and leaked down and soaked into the shoe, and soaked into the bottom legs of the jeans. I then unlocked the door to see two bart police standing there, with the train station janitor, and tenant. And they looked my up and down, and said “you alright?”, and i calmly looked them right in the eyes, and replied “yessir”. And proceeded to the train headed towards sf. My pant legs covering over my shoes slightly bloody, and the tops of my shoes bloody, but blended into the brown color of the boots once dried a little. Every step felt kind of wet and squishy. And went to the city like nothing happened, and smoked some much needed drugs to try, and forget the horrors of which i was living. And calmly, at peace with my accomplishments, and acceptance of my mutilated legs, and fell asleep on the sidewalk in blissful happiness of my small victories, awaiting the horrors that faced me upon waking up, and doing it all over again.

[Chip]

That's the most shocking experience that I ever did read !

Please never let that happen again !

I am glad that you made it outside the other end, so to speak, lol.

You're a really scary but resilient mofo -- I could read your stories all day

[Mr.pooper]

Thanks chip! In a odd and twisted way, the claim of the most shocking story is a compliment! Especially coming from opiophile(goddamn i miss that community)
and all the drug forums you have frequented for over a decade.

Im actually one of the nicest people ull ever meet. But i can hold my own as far as a terrifying 6’3 poverty street oriented individual.

I read somewhere that True leaders want to see everyone brought up to do just as good as them, and if possible, BETTER than them.

Its hard being an empath on the streets. Seeing people sick as fuck, and starving. If i can, i always tried to share my drugs with someone to help get them well. Or share my food. Or just talking and be emotional support to someone can make a world of difference. You cannot change the world, but in someones time of need, it changes their entire world.

[Chip]

That makes two of who are empaths and TBH, I use drugs to stop me being over-emotional ...

I have never lived on the street though, you are extremely resilient !

Don't forget to use AI tools to help you write and edit your biography

[Mr.pooper]

That makes two of who are empaths and TBH, I use drugs to stop me being over-emotional ...

I have never lived on the street though, you are extremely resilient !

Don't forget to use AI tools to help you write and edit your biography

I agree with the using drugs to not be so overly emotional. I didnt realize till the first time i used drugs that i was actually in pain my entire life. And the drugs felt like my secret magic trick to take those pile of bricks i had been carrying painfully my entire life.making decisions based off emotions results in horrible life decisions ultimately, in a lot of situations. A gift and a curse.

It suppressed my violent intrusive thoughts.. I had a deep fascination with reading any lore, and stories about serial killers when i was in my younger teens. I HiGHLY recommend reading up on Albert fish, or H.H Holmes as far as some of the most deranged people ive ever read about. Mr. Holmes in particular owned a hotel that stretched a city block, and the entire top floor was filled with a maze of rooms that trapped you inside, and he used multiple construction companies to build the hotel so no one could know the master plan and layout. He had rooms that only opened from the outside and fitted with gas hoses that would knock people out. Also a “body laundry shoot” to dump the bodies from the top floor to the basement where he would torture and dissect people. It was said he would completely strip bodies and sell their skeletons to schools and science facilities for education, and made a decent living from this along with his hotel. It is estimated he killed hundreds of people in his life time. Many people would go missing from the hotel, and i believe he was a prime hotel for people during the worlds fare.

As for Albert fish. His autopsy showed giant needles shoved into his pelvis, legs, and groin area. He would get pleasure from pain. He abducted a 12 year old girl. Killed her and ate her body. Then years later wrote a letter to the parents describing how he killed the girl and ate her body IN DETAIL. And was quoted saying he enjoyed a child in every state.


On the subject of serial killer, supposedly Benjamin Franklin whom is on the USD $100 dollar bill, was apparently a vicious killer. Upon recently doing renovations on his old homes, they found a bunch of skeletons of kids underneath the wooden floor boards. Apparently he was a pedo, and child murderer. America was founded by some sick fucks.

Fun fact: George Washington used to pull the teeth of his slaves to make his dentures.

“Now that im “sober”, I dont need drugs. The only rush i need today, is the one you get from committing a murder.”-Gandhi

[alpha]

I remember you from the old phile Mr. P.

Love your recollection, and it makes me miss OP so much, such a shame it crashed and burned under Jonny.

Some of my favorite posters were Stugots, Count Zero, Paups & Than, and our very own dancing bear!  And who was the old biker with such great recollections?

Keep up the writing, and let us know about your book.  I'll be first in line!

Alpha

[Chip]

The old lovable biker was Duckfeet, IIRC -- but he passed away like Than and Paups, Chopstix, and quite a few others.

Don't be a stranger, the site will stay active for as long as I'm alive (and beyond as I have found a capable technician to keep the fires burning)

[alpha]

Thanks Chip, it was in fact Duckfeet!  I have been absent from the community except for Poppycop's email chain, and am living a life of quiet maintenance.  I'm afraid to source anything from the street, and don't want to fuck up my medical lifeline, so gone are the days of excess.

Alpha