Acta Scientific Otolaryngology (ASOL) (ISSN: 2582-5550)

Case Report Volume 4 Issue 8

“Doctor, My Nose is Bleeding with Leech Crawling Out!” Nasal Hirudiniasis: A Rare Cause of Unilateral Epistaxis

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


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


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  2. Santanu Dutta., et al. “Epistaxis Due to Leech Infestation in Nose: A Report of Six Cases and Review of Literature”. Indian Journal of Otolaryngology and Head and Neck Surgery 1 (2016): 42-45.
  3. Qian Cai., et al. “Negative suction approach to remove living leeches from the nasal cavity”. American Journal of Otolaryngology5 (2015): 657-659.
  4. Kalra Sarathi. “Nasal leech infestation causing persistent epistaxis”. Journal of Emergencies, Trauma, and Shock 3 (2011): 413-414.
  5. Charles M Lent. “Serotonergic modulation of the feeding behavior of the medicinal leech”. Brain Research Bulletin6 (1985): 643-655.
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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: © 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.


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