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August 1969

Epistaxis and Hemoptysis Due to Hirudo medicinalis (Medical Leech)

Author Affiliations

Shiraz, Iran
From the Department of Otolaryngology, Pahlavi University Medical School, Shiraz, Iran.

Arch Otolaryngol. 1969;90(2):178-179. doi:10.1001/archotol.1969.00770030180017

EPISTAXIS and hemoptysis due to a leech in the upper respiratory tract has been known for centuries.1 Although extremely rare in western countries, it is by no means uncommon in Asia and Africa.2,3 In the past eight years, no fewer than 54 cases have been treated in this department. They form the basis of the present report.

Case Material  Almost all the cases were farm workers or their families from nearby villages who gave a history of drinking water from open streams. Of the total of 54 cases, 47 or 87% were males. Their ages ranged from 2 to 64 years; the majority were between 30 and 40.Symptoms started within a few hours after ingestion. Often they would notice them on first waking in the morning. The first complaint was invariably bleeding. In 65%, it was hemoptysis and in 35% epistaxis. An additional symptom in the

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