title: Reach the Leech: An Unusual Cause of Hematuria.
abstract: Leeches are found in fresh water as well as moist marshy tropical areas. Orifical Hirudiniasis is the presence of leech in natural human orifices. Leech have been reported in nose, oropharynx, vagina, rectum and bladder but leech per urethra is very rare. We report a case of leech in urethra causing hematuria and bleeding disorder in the form of epistaxis and impaired clotting profile after use of stream water for ablution. The case was diagnosed after a prolonged diagnostic dilemma. Asingle alive leech was recovered from the urethra after ten days with the help of forceps. The hematuria and epistaxis gradually improved over next 48 hours and the patient became asymptomatic. Natives of leech infested areas should be advised to avoid swimming in fresh water and desist from drinking and using stream water without inspection for leeches.
authors.affiliation: Department of Rehabilitation Medicine, Combined Military Hospital (CMH), Kohat, KPK.
authors.forename: Sahibzada Nasir
authors.initials: SN
authors.lastname: Mansoor
authors.affiliation: Department of Surgery, Combined Military Hospital (CMH), Kohat, KPK.
authors.forename: Zahid
authors.initials: Z
authors.lastname: Anwar
authors.affiliation: Department of Surgery, Combined Military Hospital (CMH), Kohat, KPK.
authors.forename: Salman Najam
authors.initials: SN
authors.lastname: Sheen
mesh_terms: D000818:Animals; D004844:Epistaxis / Q000209:etiology* / Q000469:parasitology; D006417:Hematuria / Q000209:etiology* / Q000469:parasitology; D006801:Humans; D007865:Leeches; D014521:Urethra / Q000469:parasitology*