A Rare Upper Gastrointestinal Leech Infestation Causes Massive Bleeding in a 17-Month-Old Boy Admitted to Keren Zonal Referral Hospital, Keren, Eritrea

Introduction: Leeches are blood-sucking hermaphroditic parasites. They have been used for medicinal purposes for many decades. However, the ingestion and attachment of this parasite to the nasopharynx or upper esophagus were reported to cause constant bleeding, which can be life-threatening if not correctly diagnosed and controlled in places where the water is infested with leech. Case Presentation: In this study, a 17-month-old boy with serious gastrointestinal bleeding, epistaxis, dry cough, melena, and severe anemia causing cardiorespiratory disturbance presented to our unit has been reported. Severe normocytic normochromic anemia with leukocytosis was revealed by hematologic investigations. Initial investigations revealed no cause for it. The patient received multiple transfusions of Erythrocyte suspension along with other supportive interventions. Despite all the steps, the bleeding continued until the fourth day of entry, when a 7 cm long leech was removed from the oropharyngeal region. The bleeding ceased immediately after the removal of the leech and the patient was released from the hospital in decent health later. Conclusion: In areas where epistaxis, hematemesis, gastrointestinal bleeding, and severe anemia are of uncertain cause, leech infestation should be considered.