An unusual cause of unilateral epistaxis: a leech in the nose
Case report published in Revista do Instituto de Medicina Tropical de Sao Paulo (2025)
Abstract
Leeches are segmental worms commonly found in fresh water in tropical regions. They can enter the human body via the consumption of contaminated water or through the mouth and nose during washing, generally affecting the upper airway and digestive tract. During the blood-sucking process, the leech releases the anticoagulant enzyme "hirudin" from the wound site into the host's circulation together with an anesthetic to prevent the host from feeling its attachment. Leech endoparasitism is a very rare cause of epistaxis. We report a case of a living leech lodged in the posterior nasal floor in a patient that presented to the emergency department with unilateral epistaxis and a difficult diagnosis.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Leeches are segmental worms commonly found in fresh water in tropical regions.
Por qué esto importa para la hirudoterapia
This case report details a patient who presented with unilateral epistaxis caused by a living leech lodged in the posterior nasal floor. The abstract specifically notes the leech's blood-sucking mechanism, highlighting the release of the anticoagulant enzyme "hirudin" and an anesthetic to prevent the host from feeling the attachment. For the American Society of Hirudotherapy, this illustrates the in vivo pharmacological action of leech secretions, particularly hirudin's anticoagulant effects causing prolonged bleeding. The limitation is that this is an isolated case of accidental leech endoparasitism rather than a clinical trial of therapeutic hirudotherapy, thus offering indirect clinical pharmacological observations rather than therapeutic efficacy data.
Citación
An unusual cause of unilateral epistaxis: a leech in the nose
Yasar M · Revista do Instituto de Medicina Tropical de Sao Paulo, 2025
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: June 18, 2026