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BMC Pediatrics
Published in: BMC Pediatrics 1/2022

Open Access 01-12-2022 | Tarry Feces | Case report

Manifestation of leech infestation as severe gastrointestinal bleeding in a 3-year-old boy: a case report and review of the literature

Authors: Hamid Reihani, Ali Ghanei-Shahmirzadi, Sara Salehi, Narges Ansari-Charsoughi, Fereshteh Karbasian, Mohammad-Hadi Imanieh

Published in: BMC Pediatrics | Issue 1/2022

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Abstract

Background

Leeches are a class of hermaphroditic parasites that can attach to various body parts and start sucking blood. Gastrointestinal (GI) bleeding due to leeches is a rare phenomenon that is more common in less developed countries. Common symptoms include melena, hematemesis, pallor, weakness, and fatigue. Due to the similar symptoms of this issue to the main differential diagnoses of GI bleeding in pediatrics, such as diarrhea, constipation, diverticulitis, esophagitis, and anal fissures, it is challenging to differentiate it from the rest.

Case presentation

We present a three-year-old boy who was transferred to our center with hematemesis, tarry stool, and a drop in hemoglobin level. He finally was diagnosed with a leech in his stomach.

Conclusions

In less developed counties, the inability to reach safe drinking water, swim in lakes or springs, and inadequate awareness of public health information among individuals can be risk factors for leech infestation.
Literature
1.
Mumcuoglu KY. 60 - Other Ectoparasites: Leeches, Myiasis and Sand Fleas. In: Farrar J, Hotez PJ, Junghanss T, Kang G, Lalloo D, White NJ, editors. Manson's Tropical Infectious Diseases (Twenty-third Edition). London: W.B. Saunders; 2014. p. 843–7.e1.
2.
Al-Hadrani A, Debry C, Faucon F, Fingerhut A. Hoarseness due to leech ingestion. J Laryngol Otol. 2000;114(2):145–6.CrossRef
3.
Cundall DB, Whitehead SM, Hechtel F. Severe anaemia and death due to the pharyngeal leech Myxobdella africana. Trans R Soc Trop Med Hyg. 1986;80(6):940–4.CrossRef
4.
Joslin J, Biondich A, Walker K, Zanghi N. A comprehensive review of hirudiniasis: from historic uses of leeches to modern treatments of their bites. Wilderness Environ Med. 2017;28(4):355–61.CrossRef
5.
Demirören K, Calişkan U. Unexpected result in the etiological approaching to an anemic case: a leech infestation. Pediatr Hematol Oncol. 2003;20(7):547–50.CrossRef
6.
Tilahun T, Babu H, Berhane M. Leech in the rectum causing lower GI bleeding in a four years old child: a case report. Ethiop J Health Sci. 2020;30(6):1055–7.
7.
Taskesen M, Katar S, Basçik H. An unusual cause of gastrointestinal bleeding and severe anemia in a child: leech infestation. J Trop Pediatr. 2009;55(5):338–9.CrossRef
8.
El Koraichi A, Ayoubi A, Benjelloun MY, Bentalha A, El Kettani SE. Melena revealing a nasopharyngeal leech: a paediatric case. Arab J Gastroenterol. 2014;15(1):36–7.CrossRef
9.
Al B, Yenen ME, Aldemir M. Rectal bleeding due to leech bite: a case report. Ulus Travma Acil Cerrahi Derg. 2011;17(1):83–6.CrossRef
10.
GB W. Leeches and leech infestation. Mansons Trop Dis. 1998;20:1523–5.
11.
Bergua A, Vizmanos F, Monzon F, Blasco R. Unavoidable epistaxis in the nasal infestation of leeches. Acta Otorrinolaringol Esp. 1993;44(5):391–3.
12.
Kani HT, Aydin Y, Yalcin N, Kaymakci M, Akin H. Hypopharyngeal hirudiniasis presenting as hematemesis. Endoscopy. 2014;46(Suppl 1):UCTN:E550.
13.
Narayan J, Nath P, Singh A, Padhi PK, Parida PK, Pati GK, et al. Leech infestation presenting as severe rectal bleeding. J Digest Endosc. 2017;8(3):132–3.CrossRef
14.
Mamoudou D, Diarra M, Ahidan R, Garba M, Idrissi M, Hida M. Upper gastrointestinal bleeding revealing a leech. Pan Afr Med J. 2015;22:155.
15.
Abuhandan V, Calik M, Demir N, Aycicek A. A Case of Hirudiniasis with Upper Gastrointestinal Bleeding. J Emerg Med Case Rep. 2012;3:91–2.
16.
Rafeey M, Jabbari-Mogaddam Y. Intermittent gastrointestinal bleeding in a child: leech infestation. Iran J Pediatr. 2012;22(4):572–3.
17.
Basu S, Chandra PK, Basu S. A leech in the large bowel. J R Soc Med. 2004;97(2):83.CrossRef
18.
Raj SM, Radzi M, Tee MH. Severe rectal bleeding due to leech bite. Am J Gastroenterol. 2000;95(6):1607.
19.
Iraqi MR, Squali FZ. Hematemesis and respiratory airway obstruction due to leeches. Arch Pediatr. 1999;6(4):479–80.CrossRef
20.
Estambale BB, Knight R, Chunge R. Haematemesis and severe anaemia due to a pharyngeal leech (Myxobdella africana) in a Kenyan child: a case report. Trans R Soc Trop Med Hyg. 1992;86(4):458.CrossRef
21.
el-Awad ME, Patil K. Haematemesis due to leech infestation. Ann Trop Paediatr. 1990;10(1):61–2.
22.
Singh M, Naim AF. Respiratory obstruction and haematemesis due to leech. Lancet. 1979;2(8156-8157):1374.
23.
Giannella RA, Broitman SA, Zamcheck N. Influence of gastric acidity on bacterial and parasitic enteric infections. Ann Intern Med. 1973;78(2):271–6.
24.
Fisher L, Fisher A. Acid-suppressive therapy and risk of infections: pros and cons. Clin Drug Investig. 2017;37(7):587–624.CrossRef
Metadata
Title
Manifestation of leech infestation as severe gastrointestinal bleeding in a 3-year-old boy: a case report and review of the literature
Authors
Hamid Reihani
Ali Ghanei-Shahmirzadi
Sara Salehi
Narges Ansari-Charsoughi
Fereshteh Karbasian
Mohammad-Hadi Imanieh
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2022
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-022-03778-1

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