title: Nasal leech infestation: report of seven leeches and literature review.
abstract: Nasal leech infestation rarely occurs in society today and it is usually reported as an anecdote. In this study, we present seven nasal leeches in six patients from 1984 to 2008. All patients initially presented with epistaxis. Four patients were less than 8 years old and two patients were older than 60 years old. All patients had spent time in rural streams 2 weeks to 2 months before the symptoms occurred. All of the seven leeches were removed smoothly and one leech migrated to the oropharynx during the operation. The length of the leeches ranged from 2 to 12 cm with an average length of 4.6 cm. Attention should be given to nasal leech infestation, especially in children and senior citizens who have visited rural streams and have been exposed to freshwater. One of our patients had two leeches lodged in his nasal cavities. Therefore, it is also important to re-examine both nasal cavities after the removal of one leech.
authors.affiliation: Department of Otolaryngology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, #123, Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung 833, Taiwan.
authors.forename: Wei-Chih
authors.initials: WC
authors.lastname: Chen
authors.forename: Chih-Yen
authors.initials: CY
authors.lastname: Chien
authors.forename: Chao-Hui
authors.initials: CH
authors.lastname: Yang
authors.forename: Jung-Hui
authors.initials: JH
authors.lastname: Li
authors.forename: Chung-Feng
authors.initials: CF
authors.lastname: Hwang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004478:Ectoparasitic Infestations / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D004724:Endoscopy; D004844:Epistaxis / Q000209:etiology; D005260:Female; D006801:Humans; D007865:Leeches; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000175:diagnosis / Q000209:etiology; D009668:Nose Diseases / Q000175:diagnosis* / Q000209:etiology / Q000469:parasitology / Q000628:therapy; D045483:Rivers / Q000469:parasitology; D013624:Taiwan; D014420:Turbinates / Q000469:parasitology; D055815:Young Adult