Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2025 Oct:135:111859.
doi: 10.1016/j.ijscr.2025.111859. Epub 2025 Aug 21.

Heart failure secondary to severe anemia from oropharyngeal leech infestation: A case report

Mandante Bogale Tiruneh  1 , Kidist Bogale  2 , Birhanu Ayana  3 , Gizaw Bite  4 , Mathias Amare  5 , Megbar Dessalegn  3
Affiliations
Case Reports

Heart failure secondary to severe anemia from oropharyngeal leech infestation: A case report

Mandante Bogale Tiruneh et al. Int J Surg Case Rep. 2025 Oct.

Abstract

Introduction: Leeches can rarely act as blood-sucking endoparasites. The major ways to acquire leeches are swimming in streams, ponds, and drinking contaminated water.

Case presentation: In this case, a 5-year-old female patient presented with nasal bleeding, hematemesis, and melena of two weeks' duration. She has a history of drinking water from streams and ponds. She has easy fatiguability and is unable to play as usual for a one-week duration.

Discussion: Leech infestation is described as an important source of hemorrhage and subsequent anemia, particularly in children. Leeches can feed on a volume of blood nearly 10 times their body weight. This happens after adhering and piercing the host's mucosa, a process that is painless owing to a local anesthetic released in the leech's saliva. They get access to the human body either by drinking unfiltered water or through the natural orifices of individuals who swim, play, or bathe in contaminated water. Due to this method of spread, nearly all cases have been reported from developing countries where access to and use of safe water is limited, particularly in rural areas.

Conclusion: Leech infestation should be considered as a possible cause of heart failure, unexplained hematemesis, spitting of blood and acute onset severe anemia in rural areas. Early identification and removal leech, along with timely transfusion, are critical and often life saving.

Keywords: Case report; Heart failure; Leech infestation; Severe anemia.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest There is no conflict of interest.

Figures

Fig. 1
Fig. 1
Leech retrieved from the oropharynx of a 5-year-old child.
See this image and copyright information in PMC

References

    1. Sivachandran P., et al. An overview of leech and its therapeutic applications. J. Coast. Life Med. 2015;3(5):405–413.
    1. Mekonnen D. Leech infestation: the unusual cause of upper airway obstruction. Ethiop. J. Health Sci. 2013;23(1):65–68. - PMC - PubMed
    1. Oğhan F., Güvey A., Özkırış M., Gülcan E. Oropharyngeal leech infestation and therapeutic options. Turkiye Parazitol. Derg. 2010;34(4):200–202. - PubMed
    1. Ağin H., et al. Severe anemia due to the pharyngeal leech Limnatis nilotica in a child. Turkiye Parazitol. Derg. 2008;32:247–248. - PubMed
    1. Siddiqui T.S., Qureshi I., Mufti T.S. Nasal leech-a rare cause of severe anemia. J. Ayub Med. Coll. Abbottabad. 2005;17(3) - PubMed

Publication types

LinkOut - more resources