12/25/2022 0 Comments Leech bites![]() ![]() Of these, saltwater has been shown to be effective in causing the leech to relax and release. Chemical methods have also been used including cocaine, lidocaine, and topical anesthetic spray. Various methods of leech removal have been utilized including salt, saline, vinegar, turpentine, alcohol, and heat. Initial treatment should include removal of the leech or leeches, controlling blood loss, and preventing exposure to blood-borne pathogens. A rectal exam with a proctoscope may be indicated for a patient presenting with rectal bleeding in the setting of concern for a leech bite. Depending on the age of the patient, this may need to be done under anesthesia. When there is the concern for vaginal leech infestation, a speculum exam is required. If there is a concern for a nasal leech infestation, examination with anterior rhinoscope is not sufficient, and inspection with an endoscope is usually necessary. Patients may present with recurrent epistaxis if they have a nasal leech infestation.Ī focused physical exam will be required depending on the area of concern. When the leech bite is external, patients' symptoms may include painless bleeding, bruising, itching, burning, irritation, and redness. While most leech bites are external, leeches can attach internally, and patients will present with epistaxis, hematemesis, hemoptysis, vaginal bleeding, hemoptysis, otorrhagia, and rectal bleeding. A detailed history needs to be obtained, including any recent exposure to fresh water. ![]()
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