Unique case of Leech inside nasal cavity
Dr. E. Sivakumar M.S. D.L.O.
Introduction: This is a unique case report of
a live leech present in the nasal cavity of a patient for nearly 3
30 year old male patient working in an estate reported
to my op with h/o foreign body in right nasal cavity while taking
bath in a pond. He also had h/o of bleeding from the
right nasal cavity since then. He also had pain in the right
nasal cavity and right eye for the past 7 days.
of nasal cavity was unremarkable except for excessive mucoid
discharge from the right nasal cavity. So under topical
anaesthesia diagnostic nasal endoscopy was done using a 0 degree
nasal endoscope. A live leech was seen moving inside the nasal
cavity. The same was removed.
annelids belonging to the subgroup Hirudinea.
The leeches may be classified as:
1. Fresh water
2. Terrestrial leeches
3. Marine leeches
classification is based on the habitat of the leeches. All
leech species are carnivorus feeding on a variety of invertebrates
like worms, snails etc. A few are haemorrhagic parasitic in
nature feeding on blood of animals. Like earthworms leeches
Leeches attach themselves to
humans. They are capable of sucking blood. The saliva
secreted by leech helps it to feed. The saliva of leech
contains a local anaesthetic that limits the sensation of the
host. The host donot attempt to dislodge the leech because
there is no sensation. The saliva also contains a potent vaso
dilator that dilates the blood vessels enabling the leech to feed on
the increased blood supply. Another important constituent of
its saliva is hirudin which is a potent anticoagulant which
prevents blood from clotting.
Advised procedure for
Contrary to popular belief leeches must be removed
promptly. Leech bites cause intense itching which is
normal. Leeches should not be removed by burning or applying
harsh agents like salt because it could cause the leech to damage
the wound by biting further. Damaging a leech may cause it to
regurgitate its bacteria filled stomach contents into the wound
adding to the already existing problems. Leeches have a
tendency to release their bite on exposure to menthol. This
can be effectively utilised in their removal.
Hirudiniasis: is the term used to indicate
leech invasion into a body orifice or cavity. The species
Dinobdella ferox (ferocious leech / nasal leech) are known
to invade the nasal cavity and airways. This is a life
threatening condition which could compromise the patient's
airway. These patients will benefit from gargling a solution
of 50 % alcohol. The detached leech must be spitted out.
The following points should be borne in mind:
There is absolutely no risk of substantial blood loss following
2. The wound will continue to bleed for sometime
after the leech has stopped feeding due to the effect of hirudin
present in the leech saliva. Bleeding will stop on its
3. Leeches are not normally known to transmit
blood parasites to humans.
4. Leeches are more likely
to be encountered in still waters of ponds than in flowing
rivers. They are more often found in the edges of clean /
clear water than in swamps.
View the video clipping
showing a live leech in a patient's nasal cavity
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