Nasal leech infestation causing persistent epistaxis

Foreign bodies in the nasal cavity are commonly encountered as a cause of epistaxis; however, nasal leech infestation as a cause of unilateral persistent epistaxis is very rare. Examination of nasal cavity revealed fleshy material in the left nostril, which was identified as leech. The leech was removed with the help of an artery forceps following irrigation of the left nostril with normal saline and adopting wait-and-watch policy. In developing countries, leech infestation as a cause of epistaxis should be suspected in patients with lower socioeconomic status or in those living in rural areas who give history of drinking polluted water from, or bathing in, stagnant ponds and puddles.