Uncommon cause of airway obstruction and hypovolemic shock: pharyngeal leech infestation in a rural Ethiopian child
Case report published in International Journal of Surgery Case Reports (2026)
Abstract
Leech infestation of the upper airway is an uncommon but potentially life-threatening condition, especially among children living in rural areas with limited access to safe drinking water. Early recognition and intervention are crucial to prevent severe complications such as airway obstruction and profound anemia. We present the case of an 8-year-old boy from rural North Gondar, Ethiopia, who arrived at our facility with a 5-day history of coughing up blood, blood-stained saliva, hoarseness, throat discomfort, and progressive respiratory distress. On examination, he was acutely ill, severely anemic (hemoglobin 4.0 g/dL), and in hypovolemic shock. A dark, mobile foreign body was visualized in the oropharynx. Due to the unavailability of laryngoscopy, the leech was manually extracted with MaGill forceps at the bedside. The patient received blood transfusions and antibiotics, resulting in rapid clinical improvement and an uneventful recovery. Oropharyngeal and laryngeal leech infestations, while rare, are important considerations in children from endemic regions presenting with unexplained upper airway symptoms and anemia. The parasite's anticoagulant and anesthetic secretions can delay symptom onset and diagnosis, increasing the risk of morbidity. Limited resources often hinder optimal management, but prompt recognition and removal of the leech are essential for a favorable outcome. This case highlights the importance of heightened clinical awareness of leech infestations in at-risk populations. Public health measures to improve water, sanitation, and community education are vital to prevent future cases in resource-limited settings.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Pediatric case of pharyngeal leech infestation causing airway obstruction and hemodynamic shock in rural Ethiopia — emergency airway management and removal protocol described.
Por qué esto importa para la hirudoterapia
Este informe de caso describe a un niño etíope de 8 años, procedente de una zona rural, que presentó hemoptisis, ronquera, dificultad respiratoria progresiva, anemia grave (hemoglobina 4,0 g/dL) y shock hipovolémico a causa de una infestación faríngea por sanguijuelas, que fue tratada mediante extracción manual con pinzas de Magill, transfusión sanguínea y antibióticos, con recuperación completa. El resumen señala que las secreciones anticoagulantes y anestésicas de la sanguijuela pueden retrasar la aparición de los síntomas y el diagnóstico, lo que conecta tangencialmente con las propiedades farmacológicas que subyacen a la hirudoterapia terapéutica. Sin embargo, el contexto corresponde por completo a una infestación parasitaria accidental por agua no segura en una región endémica, sin que se discuta ninguna aplicación terapéutica de sanguijuelas. Se trata de un informe de un único caso de una urgencia médica. Su relevancia para el ámbito de ASH se limita a la mención incidental de las propiedades secretoras de la sanguijuela.
Citación
Uncommon cause of airway obstruction and hypovolemic shock: pharyngeal leech infestation in a rural Ethiopian child.
Yigzaw KT et al. · International journal of surgery case reports, 2026
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026