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A rare cause of hemoptysis: Leech infestation
Ben Ghezala Hassen1, Snouda Salah2, Ferchichi Samia3, Abbes Fehmi4, Bechikh Imen2
1Medical Director Physician Director, Teaching Department of Emergency and Intensive Care Medicine, Zaghouan Hospital, Zaghouan, Tunisia.
2Medical Director, Teaching Department of Emergency AND Intensive Care Medicine,Zaghouan Hospital, Zaghouan, Tunisia.
3Medical Director, Department of Pneumology, Zaghouan Hospital, Zaghouan, Tunisia.
4Medical Director, Department of Cardiology, Zaghouan Hospital, Zaghouan, Tunisia.

Article ID: 100008CRINTBH2015
doi:10.5348/crint-2015-8-CR-3

Address correspondence to:
Snouda Salah
Regional Hospital of Zaghouan
Avenue of Environment, Zaghouan1100
Tunisia
Phone: +216 90269364
Fax: +216 72675772

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How to cite this article:
Hassen BG, Salah S, Samia F, Fehmi A, Imen B. A rare cause of hemoptysis: Leech infestation. Case Rep Int 2015;4:11–13.


Abstract
Introduction: Hemoptysis is a medical emergency. Unusual causes may exist. We report a very rare case of hemoptysis, whose cause has proven an infestation of the respiratory mucosa by a Leech.
Case Report: An 80-year old male presented with a three-day history of hemoptysis. The patient was admitted to our intensive care unit for respiratory distress and hemodynamic instability. Endoscopic examination was performed following nasal packing under local anesthesia and oxygen. A worm was noticed adhered to the bronchial mucosa. This worm was removed under local anesthesia and identified as a leech.
Conclusion: The infestation by the leech remains relatively rare. The diagnosis should be considered in the presence of unexplained hemoptysis, in patients with a recent history of drinking stream water. Endoscopy is the cornerstone in the diagnosis and the treatment of this infestation.

Keywords: Bronchial mucosa, Bronchiectasis, Hemoptysis, Leech, Tuberculosis


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Author Contributions
Ben Ghezala Hassen – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Snouda Salah – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Ferchichi Samia – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Abbes Fehmi – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Bechikh Imen – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Ben Ghezala Hassen et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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