Common things misidentified as parasites:
(1) toilet paper
(2) cotton fiber from underwear
(3) food debris
(4) plant debris
(5) earthworm, caterpillar or insect
Immature forms of bed bugs or ticks may be smaller than the full grown adult, so it is important not to exclude a significant finding by size alone.
Patients who may require a more complete evaluation:
(1) foreign born or history of foreign travel
(2) contact with pets or animals
(3) gastrointestinal or allergic complaints
(4) unexplained eosinophilia
If a pseudoparasite cannot be excluded with a hand lens then:
(1) submit the material for formal examination
(2) perform a complete blood count
(3) perform a stool exam for ova and parasites
The affect of the patient or parent can be important. It is important to distinguish concern of a parent about an unexpected finding from a psychiatric problem. A parent or patient who is very anxious about a parasite may be suffering from anxiety or depression. A patient obsessed about a parasitic infestation may have delusion of parasitosis.
