The late diagnosis of scabies in severe neurological patients may be related to the peculiarities of their general condition and lifestyle. Comorbid patients take a large number of medications for a long time, including hormonal ones, which can mask the classic manifestations of scabies. Due to the probability of the absence of characteristic complaints in patients with severe neurological pathology, we present the following clinical case. We observed patient N., who was in the department of anesthesiology-intensive care with intensive care and intensive care wards at the Federal State Budgetary Institution «FCMN» of the FMBA of Russia. Diagnosis upon admission: repeated multifocal cerebral infarction in the vertebrobasillary basin with the presence of foci of infarction in the acute/superacute stage in the basins of the main artery, right middle cerebral artery, right anterior choroidal artery, left middle cerebral artery, left superior cerebellar artery from 08/09/2024, 08/12/2024. An unspecified pathogenetic variant of TOAST. The modified Rankin scale is initially 5 points. At the time of hospitalization, 5 points (ICD 10 I63.5). Upon admission, the patient was found to have a rash, and therefore he was immediately consulted by a dermatovenerologist. Based on a set of clinical data and laboratory detection of the pathogen, patient N. was diagnosed with B 86 – scabies. At the prehospital stage, scabies was not diagnosed in a timely manner. Late diagnosis of scabies leads to the spread of the disease and the maintenance of an unfavorable epidemiological situation.