Severe anaemia and death due to the pharyngeal leech Myxobdella africana

Six cases of pharyngeal leech (identified as Myxobdella africana) are reported from a highland area of North Kenya. Three patients were severely anaemic and one died. There have been sporadic reports of leech infestation of man in East and Central Africa but these reports lack correct identification of the leech. This paper includes a detailed account of the systematics of the leech and of its habitat. The leeches were ingested accidentally by drinking water from two infested water sources. The major symptoms were a feeling of something in the throat, epistaxis and haemoptysis. On examination, pharyngeal blood was a consistent feature although the leech was rarely seen on initial inspection. Examination under anaesthesia was usually successful in locating and removing the leech. Prompt blood transfusion was life-saving in two cases. The water sources were used by both cattle and man; the cattle may also be parasitized by leeches. Methods of improving the water sources were discussed with community leaders.