Epistaxis Due to Leech Infestation in Nose: A Report of Six Cases and Review of Literature

Abstract

The aim of this study is to report unusual cause of epistaxis due to leech infestation in nose in hilly area and its management. The study was carried out for a period of 4 years (2008-2012) in a secondary level hospital in hilly area of Darjeeling, West Bengal, India with data collected from the OPD and Emergency register of the patients. This retrospective case series consisted of six cases. All the cases presented with unilateral recurrent epistaxis and foreign body nose. Anterior rhinoscopy revealed fleshy greenish brown mobile mass inside the nasal cavity which was removed by forceps. The animate foreign body was identified as leech in all the cases. To conclude, in hilly areas leech infestation can present as animate foreign body in nose and it should be considered as important cause of epistaxis.

Nasopharyngeal Leech

“…İnsandaki infestasyonları, bu suların içilmesi veya bu sularda yüzülmesi ile olur. İnfestasyonların çoğu kutanözdür ama literatürde nazofarinks, burun, orofarinks, larinks, trakea ve gastrointestinal sistemde de yerleşebileceği belirtilmiştir (1,(5)(6)(7).…”

Bronchial Leech Infestation in a 15-Year-Old Female

“…Leeches are blood sucking annelids. Leech infestation (hirudiniasis) can occur internally secondary to accidental ingestion from drinking from or swimming in contaminated water [ 8 ]. In this case report, we report a girl with bronchial hirudiniasis.…”

An Unusual Cause of Recurrent Epistaxis: Nasal Leech Infestation

“…Due to the anticoagulant enzyme hirudin, the bites may often bleed more than a normal wound, even after the leech is removed. 2 In the head and neck region, leeches commonly infest the nasal cavity, followed by the nasopharynx and oropharynx. 2 Given the inconspicuous site of infestation and the absence of pain, there is often a delayed treatment.…”

“…2 In the head and neck region, leeches commonly infest the nasal cavity, followed by the nasopharynx and oropharynx. 2 Given the inconspicuous site of infestation and the absence of pain, there is often a delayed treatment. Complications such as anemia, airway obstruction, and hemoptysis have been reported.…”

“…Complications such as anemia, airway obstruction, and hemoptysis have been reported. 2,3 Though a common symptom, recurrent epistaxis should never be overlooked as the implications may be consequential. The possibility of a nasal leech infestation should be suspected especially with a recent travel history to the tropics.…”