A 45-year-old woman with a history of depression treated with fluoxetine.
The patient complained of discomfort due to the anus of "bichitos" which was caused by the whole of her body.
The doctor requested a EPSD, Graham test and acarotest, all three with negative results.
The patient came to the internist, who empirically indicated albendazole 400 mg for two days and referred her to dermatology.
Dermatologists requested new stool samples, all negative for intestinal parasites, and the patient was referred to a parasytologist.
In the directed interview, she lived in an urbanized house and did not have pets for fear of contagion with "bis".
In addition, she denied sexual activity due to mental illness associated with her partner's bisexuality, nor did she receive visits because she could present intestinal or cutaneous infections.
Physical examination revealed no skin lesions or appendages.
The patient was referred to the consultation with the "biosis" that captured a piece of hygienic paper.
Macroscopic examination of the bitumens corresponded to a mixture of rutted bread and sand.
After the non-objectification of a parasitosis, the persistence of the psychiatric disorder was recommended due to parasite infestation, which refused to be evaluated.
