Posted by 
A leech in the nose is a rare parasitic infestation in humans, usually in tropical, rural areas, causing persistent nosebleeds (epistaxis), nasal obstruction, and a feeling of a moving foreign object. Leeches secrete hirudin, an anticoagulant, leading to continuous bleeding, and their presence can be difficult to detect due to their preference for the darker parts of the nasal cavity. Medical intervention, often involving forceps and tweezers, is required for removal, as prolonged infestation can lead to anemia or severe airway obstruction if the leech moves into the trachea.
Symptoms
- Epistaxis (Nosebleeds): The leech’s anticoagulant enzyme hirudin causes persistent bleeding.
- Nasal obstruction: The presence of the leech can block the nasal passage.
- Sensation of a foreign body: Patients may feel a moving object in their nose.
- Itching and discomfort: The leech can cause itching and other discomfort.
- Hemorrhagic anemia: Prolonged infestations can lead to a loss of blood.
Causes and Risk Factors
- Parasitic invasion: Leeches invade the nasal cavity through the nostrils.
- Tropical and rural environments: This type of infestation is more common in tropical areas, particularly in rural regions with fresh water sources like ponds and puddles.
Diagnosis and Treatment
- Rhinoscopy: A doctor will likely perform an anterior rhinoscopy to visualize the nasal cavity and locate the leech.
- Forceps and tweezers: Medical professionals use these tools to grasp and remove the leech.
- High index of suspicion: Doctors need to maintain a high suspicion for this condition, especially in patients with a history of exposure to fresh water in endemic areas.
Potential Complications
- Airway obstruction: If the leech migrates into the trachea or bronchi, it can cause a life-threatening airway obstruction.
- Anemia: Severe or prolonged blood loss can lead to anemia.