Case Report

A Rare and Unusual Cause of Recurrent Hemoptysis: Alive Intratracheal Leech Infestation


Hemoptysis is defined as blood expectoration from below the vocal cords. Foreign bodies inhaled or consumed can be the cause of hemoptysis. Among alive foreign objects, leech infestation happens via drinking infested bodies of water. Leech infestation in the airway might be the cause of serious complications naming dysphonia, stridor, hemoptysis, choking, respiratory distress, and foreign body sensation. Although intratracheal leech infestation has been rarely reported, in the current case, a 79-year farmer presented recurrent non massive hemoptysis. Via fiberoptic bronchoscopy, a live leech was found in the trachea of the patient and with the use of lidocaine the leech was removed. In order to avoid such incidences, governments play an important role in building and repairing infrastructures regarding sanitary water and meanwhile educating and informing their population about sanitary water consumption.

1. Ali SR, Mehta AS. Alive in the airways: Live endobronchila foreign bodies: Chest 2017; 151:481.
2. "Leech" The Editors of Encyclopedia Britannica -
3. Rahimi-Rad MH, Allizadeh E, Samareu R. (2011) Aquatic leech as a rare cause of respiratory distress and Hemoptysis. Pneumologia (Bucharest, Romania); 60(2):85-6.
4. Samaraei R. Survey of foreign Body aspiration in airways and lungs. Global Journal of Health Science, vol. 6, no. 7, pp. 10-135, 2014. View at: Publisher Site, Google Scholar.
5. Shitaye N, and Shibbabaw S. (2017) Severe anemia due to pharyngeal leech infestation; a case report from Ethiopia, BMC Surgery, vol 17, Article number:102.
6. Bilgen C, Karci B, and Uluoz. A nasopharyngeal mass: leech in the nasopharynx. International Journal of Pediatrics Otorhinolaryngology 2002; 64(1). Pp 73-76.
7. Adam R, Zakrzewski P. Therapeutic use of leeches. University of Toronto Medical Journal. 2001; 79(1): 65-67.
8. Mekonnen D. Leech infestation: the unusual cause of upper airway obstruction. Ethiopian Journal Health Sciences. 2013; 23(1):265-268.
9. Kruger C. Malleyeck I. and Olsen OH. Aquatic leech infestation: a rare cause of severe anemia in an adolescent Tanzanian girl. The European Journal of Pediatrics. 2004 163:297-299.
10. Oghan F, Guvey A, Ozkiris M, Gulcan E, Oropharyngeal leech infestation and therapeutic options. Türkiye Parazitoloji Dergisi. 2010; 34(4):00-2.
11. Ralston S, Hill V and Martinez M. Nebulized Hypertonic Saline without Adjunctive Bronchodilators for Children with Bronchiolitis. Official Journal of the American Academy of Pediatrics. 2010; 126(3):e520-5.
IssueVol 59, No 7 (2021) QRcode
SectionCase Report(s)
Hemoptysis Intratracheal Leech

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Nadi E, Naderishahab M. A Rare and Unusual Cause of Recurrent Hemoptysis: Alive Intratracheal Leech Infestation. Acta Med Iran. 2021;59(7):454-456.