Unnoticed freshwater leech as a hidden cause for recurring epistaxis: a case series and review of literature conducted at Tertiary Care Hospital Sikkim, North East India

Abstract

Background While leeches as intranasal foreign bodies are not frequently encountered, they can be one of the causes of epistaxis. The aim of the study is to raise awareness among healthcare professionals about the possibility of patients from leech endemic regions presenting with epistaxis. Case presentation We present a series of epistaxis cases due to intranasal leech infestation. In our series of 10 cases, there were 7 male and 3 female patients, aged between 2 and 53 years old. The duration of the complaint ranged from 1 to 5 weeks. All patients experienced with blood-stain nasal discharge or frank nasal bleeding at some point and most of them have a history of leech infestation from spring water as a local source. This article presents our approach to managing nasal leech infestation as epistaxis and outlines the precautionary measures taken for the retrieval of this living foreign body. Conclusion Details of the history must be taken before concluding the diagnosis. Maintain a high index of suspicion of leech infestation as a hidden cause of epistaxis especially in patients coming from endemic areas.