Unusual case of penile ecchymosis
Case report published in Pediatr Emerg Care (2019)
Abstract
Hirudin is a potent anticoagulant found in the salivary glands of several species of leeches. We report a case of direct hirudin exposure after suspected leech bite causing significant penile ecchymosis. Diagnosis was not apparent on initial evaluation but made after a thorough history was obtained and the leech was found in the lining of his swim trunks, which he left at home. Although this presentation mimics several other potentially serious conditions, treatment is largely observational with anticipated rapid improvement over the course of hours without intervention.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Pediatric penile-ecchymosis case from direct hirudin exposure after suspected leech bite in swim trunks. Largely observational management with anticipated rapid spontaneous improvement.
Why This Matters for Hirudotherapy
This case report describes a patient who presented with significant penile ecchymosis following a suspected leech bite, with hirudin—a potent anticoagulant found in the salivary glands of several leech species—identified as the causative agent after the leech was discovered in the lining of the patient's swim trunks. The authors note that the presentation mimics several potentially serious conditions but that treatment is largely observational with anticipated rapid improvement over hours without intervention. This case is relevant to ASH's domain as it documents a direct clinical effect of hirudin exposure from a leech bite and illustrates the anticoagulant potency of leech salivary secretions. The limitation is that this is a single case report of an accidental leech bite rather than medicinal hirudotherapy, and no laboratory coagulation values or follow-up duration are reported in the abstract.
Citation
Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026