Nasal Leech Infestation Causing Persistent Epistaxis in a 3-Year-Old Girl: A Case Report

Abstract

Persistent epistaxis can be caused by foreign bodies in the nasal cavity, including both inanimate objects and living organisms. Although rare, nasal leech infestation can cause unilateral epistaxis. We report the case of a 3-year-old girl with a 3-week history of severe left-sided epistaxis. The persistent severe epistaxis resulted in severe anemia. An examination of the nasal cavity revealed fleshy material in the left nasopharynx, which was subsequently identified as a leech. Following irrigation of the left nasopharynx with normal saline and a period of observation, the leech was removed using artery forceps under rhinoscopic guidance. The anemia was treated with packed red blood cell transfusion, and the patient was discharged after 3 days. Nasal leech infestation should be considered in the differential diagnosis of persistent epistaxis, particularly in patients living in developing countries or those with a history of bathing in or drinking contaminated water from stagnant ponds or puddles.