A Rare and Unusual Cause of Epistaxis

Abstract

INTRODUCTION: Leeches are blood sucking parasites of the phylum Amelida subgroup Hirudinea. Leech infestation is known as hirudiniasis. Endoparasitic infestation by leech is rarely reported in literature. The parasites enter the body by bathing or drinking infected water. They attach to the mucosa of the aerodigestive tract and suck blood whereby greatly increasing in size, with resultant clinical symptoms. CASE REPORT: A 52 year male presented with unilateral epistaxis and nasal obstruction. Nasal examination revealed a live leech. The leech was found lodged in the nasopharynx. The patient was unaware of the leech in his body. The leech was removed alive with the use of a nasal endoscope under local anaesthesia. DISCUSSION : Leech infestation is a rare cause of epistaxis. Absence of pain and difficult visualisation make the diagnosis difficult and delayed. There are various methods described in literature to remove leeches from the body. General anaesthesia may be required for its removal especially in children and when the leech is lodged in the tracheobronchial tree. CONCLUSION : The aim of presentation is to report a rare unusual cause of epistaxis, leech infestation of the nasopharynx and method of removal of the leech safely under local anaesthesia.

Keywords

• Leeches
• Epistaxis
• Nasopharynx.