Upper airway obstruction and hemoptysis due to a leech infestation in a child

This paper presents the case of a 12-year-old child who presented with an 8-day history of cough, respiratory distress, and hemoptysis. He was admitted first to the pediatric intensive care unit to reestablish hemodynamic and respiratory stability. The chest X-ray showed a bilateral alveolar-interstitial syndrome. Four hours after admission, he had a coughing fit, moderately abundant hemoptysis, and a leech appeared in his mouth, which was removed by the mother. Symptoms completely disappeared afterwards. Endoscopy and ear-throat-laryngeal examination done thereafter were normal. The presence of a leech in the larynx has been rarely described in children, but is not a rare cause of hemoptysis. Extraction is imperative and should be performed as soon as the diagnosis is made to avoid a fatal progression. Prevention remains the best treatment.