Heart failure secondary to severe anemia from oropharyngeal leech infestation: a case report
Case report published in Int J Surg Case Rep (2025)
Abstract
INTRODUCTION: Leeches can rarely act as blood-sucking endoparasites. The major ways to acquire leeches are swimming in streams, ponds, and drinking contaminated water. CASE PRESENTATION: In this case, a 5-year-old female patient presented with nasal bleeding, hematemesis, and melena of two weeks' duration. She has a history of drinking water from streams and ponds. She has easy fatiguability and is unable to play as usual for a one-week duration. DISCUSSION: Leech infestation is described as an important source of hemorrhage and subsequent anemia, particularly in children. Leeches can feed on a volume of blood nearly 10 times their body weight. This happens after adhering and piercing the host's mucosa, a process that is painless owing to a local anesthetic released in the leech's saliva. They get access to the human body either by drinking unfiltered water or through the natural orifices of individuals who swim, play, or bathe in contaminated water. Due to this method of spread, nearly all cases have been reported from developing countries where access to and use of safe water is limited, particularly in rural areas. CONCLUSION: Leech infestation should be considered as a possible cause of heart failure, unexplained hematemesis, spitting of blood and acute onset severe anemia in rural areas. Early identification and removal leech, along with timely transfusion, are critical and often life saving.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Heart-failure case secondary to severe anemia from oropharyngeal leech infestation.
Por qué esto importa para la hirudoterapia
Este reporte de caso describe a una niña de 5 años que presentó epistaxis, hematemesis y melena de dos semanas de evolución, con antecedente de ingesta de agua de arroyos y estanques. El resumen señala que las sanguijuelas pueden ingerir volúmenes de sangre hasta 10 veces su peso corporal y liberan un anestésico local en su saliva que hace indolora la adhesión a la mucosa, y concluye que la infestación por sanguijuelas debe considerarse como una posible causa de insuficiencia cardíaca, hematemesis inexplicada y anemia aguda grave en áreas rurales. Para la ASH, este reporte aporta información biológica relevante sobre la mecánica de alimentación de las sanguijuelas y las propiedades de su saliva, aunque desde una perspectiva parasitológica más que terapéutica. Salvedad: se trata de un reporte de caso único de infestación parasitaria accidental, no de hirudoterapia terapéutica; el escenario clínico difiere fundamentalmente de la aplicación intencional de sanguijuelas.
Citación
Heart failure secondary to severe anemia from oropharyngeal leech infestation: a case report.
Tiruneh et al. · International journal of surgery case reports, 2025
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026