Ein Wan Chin¹* and Shahrul H²

¹Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
²Department of Otorhinolaryngology, Hospital Ampang, Selangor, Malaysia

*Corresponding Author: Ein Wan Chin, Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Received: June 15, 2022; Published: July 26, 2022

Abstract

Introduction: Nasal hirudiniasis is rare and usually manifest as unilateral epistaxis, nasal blockage or foreign body sensation. Leech infestation predominantly occurred in children and elderly who lives in tropical areas, who adopted the habit of drinking polluted water from or swim in the streams or stagnant ponds. Diagnosis can be ascertained with endoscope. Treatment is to remove by forceps or negative suction.

Report: Hereby, we report a healthy teenager Burmese gentleman who gave a history of drinking drain water two weeks ago with complaint of left nostril recurrent epistaxis and foreign body sensation. Further history, the leech crawling out from patient’s left nostril on and off when he slept and witnessed by his roomate. On physical examination misting over left nostril was nil, anterior rhinoscopy findings noted left inferior turbinate is severe hypertrophy and pale with pooling of clear nasal discharge. Rigid nasoendoscopy identified the leech was reside in the middle meatus, surrounding mucosa was pale and hypertrophied. Leech was successful removed as a whole with negative suction and Tilley’s forceps. Post procedure patient was well and discharged with tab augmentin and alkaline nasal douching for 1 week. No residual symptoms in the follow up.

Conclusions: In conclusion, medical practitioner should suspect nasal hirudiniasis in patients present with unilateral foreign body sensation, epistaxis or nasal block who gives history of unsafe water drinking habit or bath in infested water. Education to the population to prevent recurrence is important.

Keywords: Nasal Hirudiniasis; Children; Nose; Bleeding

References

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Citation

Citation: Ein Wan Chin and Shahrul H. ““Doctor, My Nose is Bleeding with Leech Crawling Out!” Nasal Hirudiniasis: A Rare Cause of Unilateral Epistaxis".Acta Scientific Otolaryngology 4.8 (2022): 47-49.

Copyright

Copyright: © 2022 Ein Wan Chin and Shahrul H. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.