title: An unusual cause of dysphonia with hemoptysis: a laryngeal live leech.
abstract: BACKGROUND
  Foreign bodies in the upper airway are one of the most challenging otolaryngology emergencies and have various presentations depending on their physical properties and location. Leeches are blood-sucking hermaphroditic worms that vary in color, length, and shape. They usually reside in fresh-water streams and lakes. When rural untreated water is drunk, leeches may localize in the nose, pharynx, and esophagus, or rarely in the larynx.
  
  
  METHODS
  This case is a man who was referred to our otolaryngology clinic with a complaint of hemoptysis and mild respiratory distress. The patient's symptoms were all relieved post operatively and he was discharged on the second day following the procedure.
  
  
  CONCLUSIONS
  Leeches should be suspected as an airway foreign body in patients with a recent history of drinking stream water.
authors.affiliation: Sinus and Surgical Endoscopic Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Rajati
authors.affiliation: Department of Otorhinolaryngology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Shirin
authors.initials: S
authors.lastname: Irani
authors.affiliation: Sinus and Surgical Endoscopic Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Khadivi
authors.affiliation: Sinus and Surgical Endoscopic Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Bakhshaee
keywords: Dysphonia; Hemoptysis; Leech