Delusory parasitosis: Reports, reality, and rationalizations

The Plant and Pest Diagnostic Clinic of Ohio receives numerous requests each year from individuals desperate for an answer to their question of "What's biting me?"  This is a question many entomologists are asked throughout their career and it rarely has an easy answer.  The disproportionate majority of samples received at our clinic have no insect or arthropods present but this answer is rarely if ever a relief to the client.  Websites, media reports, fabricated research and accidental false confirmations by friends and family often lead to these individuals making unhealthy decisions and increased levels of anxiety which may make the symptoms worse.  Over the course of ten years our clinic has analyzed these samples and identified very few actual insect specimens with certain patterns evident in the few confirmations.  Carpet beetles (Dermestidae), Springtails (Collembola) are the predominantly confirmed groups and both have been backed up by sketchy, old, and/or falsified reports that are used as supporting evidence.  Mites and bed bugs are the most common reports with bed bugs in their home with the specimens later identified as carpet beetles.  When no mites can be found the rationalization is that the mites have hopped away or they just weren't in that sample.  We summarize the previous ten years or data including correlations and potential causitive factors.