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Unilateral epistaxis after swimming in a stream
C K Chow1, S S Y Wong, A C W Ho
1Division of Otorhinolaryngology, Department of Surgery, University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong. ckchow@hkucc.hku.hk
Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi
|April 9, 2005
Summary
A rare case of nasal leech infestation was found in a Chinese woman presenting with epistaxis. The live leech was successfully removed from her nasal cavity and maxillary sinus.
Area of Science:
- Otorhinolaryngology
- Parasitology
- Tropical Medicine
Background:
- Nasal and sinus infestations by leeches are uncommon, particularly in non-endemic regions.
- Patients may present with nonspecific symptoms such as epistaxis and nasal obstruction.
Observation:
- A 55-year-old woman presented with a 3-week history of left-sided epistaxis and nasal obstruction after swimming in a freshwater stream.
- Endoscopic examination revealed a live leech in the left middle meatus extending into the left maxillary antrum.
Findings:
- The leech was successfully removed under local anesthesia.
- Magnetic resonance imaging confirmed no further leeches in the sinonasal area.
- The infestation persisted due to an inconspicuous location and lack of pain.
Implications:
- This case highlights a previously unreported form of leech endoparasitism in the sinonasal tract.
- Early diagnosis and removal are crucial for managing such rare infestations.
- Awareness of potential aquatic-borne parasitic infections is important for clinicians, especially in travelers or individuals with relevant exposure history.
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