A Rare Cause of Hemoptysis: Oropharyngeal Leech

We report the case of a 33-year-old patient who presented with dyspnea and hemoptysis due to an oropharyngeal leech infestation. The patient was a shepherd and his detailed history revealed that he had been drinking water from natural springs. In the examination, a vivid dark green colored foreign body moving towards the nasopharynx and hypopharynx was detected in the oropharynx. The leech was removed under local anesthesia by gently grasping with the help of a long clamp. It should be noted that leeches are common in rural water sources and they can cause severe morbidity and even mortalities due to serious complications such as severe anemia and airway obstructions. A thorough oral and oropharyngeal examination will be sufficient to identify such cases, indicating the importance of physical examination in patients that present with otherwise unexplained airway obstruction and hemoptysis.