A Rare Cause of Hypovolemic Shock in Prepubertal Girl: Vaginal Leech Infestation
Case report published in Case Rep Obstet Gynecol (2019)
Abstract
Vaginal bleeding in girls is an alarming symptom for both parents and pediatricians. Serious underlying causes should be always evoked. Case Report. We describe here a 9-year-old girl who was admitted at our emergency department for vaginal bleeding and severe anemia. No history of trauma and no evidence of prior abuse were reported by the parents. Full Blood Count showed profound anemia (hemoglobin at 4 g/dl). The child was managed as a hypovolemic shock and resuscitated with intravenous fluids and urgent blood transfusion. Gynecologic examination found a live leech at the vulva and the extraction was facilitated by applying a saline solution. The child was clinically stable and discharged home the next day with ambulatory treatment. Conclusion. This case emphasizes that a through external genital exam with possible exam under anesthesia should be undertaken in all girls with unexplained vaginal bleeding and that in those living in rural areas without potable water, leech infection should be considered.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Case of a 9-year-old girl in Morocco with vaginal bleeding and profound anemia (hemoglobin 4 g/dL) requiring transfusion; gynecologic examination identified a live leech at the vulva.
Por qué esto importa para la hirudoterapia
This case report describes a 9-year-old girl admitted with vaginal bleeding and severe anemia (hemoglobin 4 g/dL), managed as hypovolemic shock with IV fluids and urgent transfusion, in whom gynecologic examination found a live leech at the vulva extracted using saline solution. The authors emphasize thorough external genital exam and considering leech infestation in girls from rural areas without potable water presenting with unexplained vaginal bleeding. This article documents pathogenic leech parasitism causing hypovolemic shock, not therapeutic hirudotherapy or the leech secretome, and thus has no direct relevance to ASH's domain.
Citación
A Rare Cause of Hypovolemic Shock in Prepubertal Girl: Vaginal Leech Infestation.
Lahmini W et al. · Case reports in obstetrics and gynecology, 2019
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: June 18, 2026