Leech infestation causing upper airway obstruction and severe anemia in a three year old child in rural Ethiopia

Abstract

Background: Leeches are hermaphrodites that rarely infest humans. When they infest humans, they most commonly enter in the endoparasite form when a human host drinks or swims in leech-infested water.

Case presentation: A three-year old female presented to Arba Minch General Hospital with three days of difficulty breathing and ten days of blood-stained saliva. She was reported to have been drinking spring water that was known to be infested by leeches. She was diagnosed with upper airway obstruction and severe anemia secondary to leech infestation by direct laryngoscopy. The leech was removed with McGill’s forceps. She was transfused with three units of whole blood and observed for 48 hours prior to discharge.

Conclusion: Although rarely seen in patients living in rural endemic areas, leech infestation should be considered in patients presenting with both upper airway obstruction and severe anemia. Increasing the availability of clean water in all rural areas is strongly recommended. Where this is not possible, the community should be educated on the importance of using boiled and filtered water for human consumption.