Otorrhagia bleeding due to leech bite


Department of Otolaryngology, Al-Zahra hospital, Isfahan University of Medical Science, Isfahan, Iran


Leeches are blood-sucking hermaphroditic parasites that attach to vertebrate hosts, bite through the skin, and suck out blood. When leeches feed, they secrete an anticoagulant (hirudin), which helps them get a full meal of blood. This is the first report of leech removal from external auditory canal. Previous leech involvement cases were explained in nasopharynx, larynx, pharynx, eye, and gastrointestinal tract. Prominent sign of all cases was active bleeding from the leech attachment site; that stopped with leech removal. A 24-year-old man was presented to Al-Zahra hospital with left otorrhagia and otalgia from 2 days ago. After suction of ear a small soft foreign body was seen in the external ear near the tympanic membrane, then the ear filled with glycerine phenice, the patient explained decreased movement of foreign body. Four hours later the bloody discharge stopped and otalgia decreased. After suction of clots, a leech was extruded from external auditory canal by alligator. Leech infestation is a rare cause of otorrhagia and should be suspected in the endemic region in all of unusual bleeding; it can be diagnosed and treated by exact inspection and removal.


1. Fooanant S, Puntasri W, Manorot M, Niwasabutra S. A leech in the nasal cavity: Case report. Chiang Mai Med Bull 2006;45:27-30.  Back to cited text no. 1
2. Fooanant S, Puntasri W, Manorot M, Niwasabutra S. Available from: http://www.en.wikipedia.org/wiki/Hirudo_medicinalis [Last accessed on 2011 Nov 09].  Back to cited text no. 2
3. Al B, Yenen ME, Aldemir M. Rectal bleeding due to leech bite: A case report. Ulus Travma Acil Cerrahi Derg 2011;17:83-6.  Back to cited text no. 3
4. Ugur KS, Gunduz M. Leech in the Nasopharynx: An Uncommon Cause of Epistaxis. Otolaryngol Head Neck Surg 2011;145:176-7.  Back to cited text no. 4
5. Tufek A, Karaman H, Yýldýrým ZB, Celik F, Tokgöz O, Akdemir MS, et al. Unexpected foreign bodies in larynx: two cases report. Paediatr Anaesth 2011;21:467-8.  Back to cited text no. 5
6. Çoban S, Tutal E, Alpay D, Köklü S. An unexpected cause of severe anemia in an adult patient: A pharyngeal leech (with video). Gastrointest Endosc 2011;73:360-1.  Back to cited text no. 6
7. Tenkir A, Tibebu T. Leech on the eye in a child. Ethiop Med J 2010;48:177-80.  Back to cited text no. 7
8. Dey R, Dey S. Ocular leech infestation. Arch Iran Med 2010;13:440-2.  Back to cited text no. 8
9. Maguire J, Splielman A, Braunwald E, Faci A, Kasper D, Jameson L. Harrissons S. Ectoparasite. In: Principles of internal medicine. Vol. 4, 15 th ed. New York: McGraw Hill; 2005. p. 2624.  Back to cited text no. 9
10. Guerrant RL, Walker DH, Weller PF. Essentials of tropical infectious diseases. Philladelphia: Churchill Livingstone; 2001. p. 607-8.  Back to cited text no. 10