A Rare Case of Infantile Otalgia and Otorrhagia due to Alive Leech Bite

Pediatric ear infestation with leeches is a rare event; however, it can lead to serious complications. Leeches usually make their way into the human body through bathing with or drinking of contaminated water from nonhygienic sources and swimming in infested water. To our knowledge, this is the first report of leech removal from the external auditory canal in an infant. We described the case of a 3-month-old infant who presented to our institution with sudden left otalgia, otorrhagia, poor oral intake, and prolonged crying for 4 days, culminating in a single epileptic attack, drowsiness, and electrolyte disturbances. Microscopic visualization of the left ear revealed minimal oozing of blood with clots obscuring the ear canal and a live motile 3 cm leech deeply seated near the tympanic membrane. Extraction was performed. The bloody discharge ceased completely and all symptoms were relieved. Leech infestation is typically considered after other potential etiologies in infants with sudden otorrhagia and otalgia living in an endemic region. It should be considered a hidden cause of pediatric discomfort. Detailed history taking and meticulous ear examinations are vital for the prompt management to avoid unnecessary computed tomography imaging and radiation, unhelpful interventions, and delayed treatment. A diagnosis was reached and treatment performed by careful inspection and leech removal, respectively.