Epistaxis and haemoptysis due to Leech Bite

Leech bite is a rare cause of GI, respiratory and genital bleeding. leech salivatory secretions contains strong anticoagulant and vasodilator substanses among them Hirudin is the most important and promotes local bleeding by thrombin inhibition and other mechanisms. Usually leeches may be swallowed by drinking stagnant or even mountain stream water and then enter the mouth and nostrils. Ingested leeches in most frequently attach to the mucosa of nose or nasopharynx leading to epistaxis and respiratory distress, but rarely, they may attach to trachea, bronchi or oesophagus and give rise to haematemesis, haemoptysis and severe respiratory distress.Case Report: A 7 years old girl, lived in one of the Kurdistanś villages admitted in Tohid hospital urgency unit with epistaxis and haemoptysis. After taking medical diagnostic measures the cause of bleeding turned out to be leech attachment to her nasopharynx. Leech was removed by means of surgical forceps. Bleeding was stopped and she was discharged. Leech bite should be considered as a rare cause of GI, respiratory and genital bleeding in regions where people drink stagnant or stream water. People living in such rural regions need more education concerning leech bite and use of suitable water.