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Aquatic leech infestation: a rare cause of severe anaemia in an adolescent Tanzanian girl.
Eur J Pediatr. 2004 Jun; 163(6):297-9.EJ

Abstract

We report on a 15-year-old girl who presented with a history of chest pain, coughing, intermittent haemoptysis, fever, pallor and vomiting to a rural hospital in Tanzania. She was severely anaemic with signs of cardiorespiratory distress. Haemoglobin was 4.8 g/dl; the chest X-ray film was normal. She required one unit of blood. After 3 days, she vomited up a small parasite which proved to be an aquatic leech. Oesophagogastroscopy, then performed, revealed four small mucosal lesions in the pharynx and upper oesophagus. No other leeches were seen. Further oesophagogastroscopy 4 days later showed a normal mucosa. The girl was discharged on iron and folic acid supplements. A small lake near her village was identified as the likely source of her infestation. The family had used the water for drinking without any precautions-Terrestrial leeches can cause profound, life-threatening anaemia, but even more so do aquatic leeches. This type is acquired while bathing or drinking unfiltered water. They attach themselves to mucous membranes, having been described in sites like conjunctiva, nose, pharynx/larynx, trachea/bronchi, oesophagus, vagina, and rectum. Especially in the airways, they can cause even fatal bleeding or obstruction. Treatment consists of removal of the leech.

CONCLUSION

In developing countries, even unusual causes like leech infestation have to be considered in the differential diagnosis of severe anaemia in children.

Authors+Show Affiliations

Haydom Lutheran Hospital, Haydom/Mbulu District, Tanzania. thea.carsten.krueger@web.deNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

15346909

Citation

Krüger, Carsten, et al. "Aquatic Leech Infestation: a Rare Cause of Severe Anaemia in an Adolescent Tanzanian Girl." European Journal of Pediatrics, vol. 163, no. 6, 2004, pp. 297-9.
Krüger C, Malleyeck I, Olsen OH. Aquatic leech infestation: a rare cause of severe anaemia in an adolescent Tanzanian girl. Eur J Pediatr. 2004;163(6):297-9.
Krüger, C., Malleyeck, I., & Olsen, O. H. (2004). Aquatic leech infestation: a rare cause of severe anaemia in an adolescent Tanzanian girl. European Journal of Pediatrics, 163(6), 297-9.
Krüger C, Malleyeck I, Olsen OH. Aquatic Leech Infestation: a Rare Cause of Severe Anaemia in an Adolescent Tanzanian Girl. Eur J Pediatr. 2004;163(6):297-9. PubMed PMID: 15346909.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Aquatic leech infestation: a rare cause of severe anaemia in an adolescent Tanzanian girl. AU - Krüger,Carsten, AU - Malleyeck,Isaack, AU - Olsen,Ole H E, PY - 2004/9/7/pubmed PY - 2004/10/27/medline PY - 2004/9/7/entrez SP - 297 EP - 9 JF - European journal of pediatrics JO - Eur. J. Pediatr. VL - 163 IS - 6 N2 - UNLABELLED: We report on a 15-year-old girl who presented with a history of chest pain, coughing, intermittent haemoptysis, fever, pallor and vomiting to a rural hospital in Tanzania. She was severely anaemic with signs of cardiorespiratory distress. Haemoglobin was 4.8 g/dl; the chest X-ray film was normal. She required one unit of blood. After 3 days, she vomited up a small parasite which proved to be an aquatic leech. Oesophagogastroscopy, then performed, revealed four small mucosal lesions in the pharynx and upper oesophagus. No other leeches were seen. Further oesophagogastroscopy 4 days later showed a normal mucosa. The girl was discharged on iron and folic acid supplements. A small lake near her village was identified as the likely source of her infestation. The family had used the water for drinking without any precautions-Terrestrial leeches can cause profound, life-threatening anaemia, but even more so do aquatic leeches. This type is acquired while bathing or drinking unfiltered water. They attach themselves to mucous membranes, having been described in sites like conjunctiva, nose, pharynx/larynx, trachea/bronchi, oesophagus, vagina, and rectum. Especially in the airways, they can cause even fatal bleeding or obstruction. Treatment consists of removal of the leech. CONCLUSION: In developing countries, even unusual causes like leech infestation have to be considered in the differential diagnosis of severe anaemia in children. SN - 0340-6199 UR - https://www.unboundmedicine.com/medline/citation/15346909/Aquatic_leech_infestation:_a_rare_cause_of_severe_anaemia_in_an_adolescent_Tanzanian_girl_ L2 - https://dx.doi.org/10.1007/s00431-004-1422-0 DB - PRIME DP - Unbound Medicine ER -