IDCases · 2026
Oropharyngeal leech infestation as an unusual cause of severe anemia and hypovolemic shock in a 2-year-old child: A case report from Ethiopia.
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Semachew Desalegn Kefale
Аннотация
BACKGROUND: Leech infestations can cause significant, often unrecognized, blood loss. This type of infestation occurs most commonly in young children living in rural settings who consume unfiltered water from rivers.
CASE PRESENTATION: A two-year-old female patient presented to a general hospital from a rural area of Ethiopia with a five-day history of epistaxis, blood-stained saliva, fatigue, and poor appetite. On examination, hemoglobin was 3 g/dL. A dark brown, mobile foreign body - subsequently identified as a leech - was found attached to the posterior oropharynx. The patient (weight 11 kg) received 20 mL/kg of intravenous fluids for resuscitation and two sequential 20 mL/kg whole-blood transfusions (cumulative 40 mL/kg) for anemia. Once stabilized, the leech was removed by direct laryngoscopy using McGill forceps. Hemoglobin had risen to 11 g/dL by the sixth hospital day, and the patient was discharged in good condition.
CONCLUSION: Oropharyngeal leech infestation should be considered in the differential diagnosis of sudden-onset epistaxis, blood-stained saliva, and severe anemia in children from rural settings who drink unfiltered river water. Early detection and removal of the leech can be lifesaving.
CASE PRESENTATION: A two-year-old female patient presented to a general hospital from a rural area of Ethiopia with a five-day history of epistaxis, blood-stained saliva, fatigue, and poor appetite. On examination, hemoglobin was 3 g/dL. A dark brown, mobile foreign body - subsequently identified as a leech - was found attached to the posterior oropharynx. The patient (weight 11 kg) received 20 mL/kg of intravenous fluids for resuscitation and two sequential 20 mL/kg whole-blood transfusions (cumulative 40 mL/kg) for anemia. Once stabilized, the leech was removed by direct laryngoscopy using McGill forceps. Hemoglobin had risen to 11 g/dL by the sixth hospital day, and the patient was discharged in good condition.
CONCLUSION: Oropharyngeal leech infestation should be considered in the differential diagnosis of sudden-onset epistaxis, blood-stained saliva, and severe anemia in children from rural settings who drink unfiltered river water. Early detection and removal of the leech can be lifesaving.