Vaginal Leech Infestation Presenting as Painless Vaginal Bleeding in a Child: A Case Report

Abstract

Background:

Leech infestation (hirudiniasis) is an uncommon parasitic condition, typically involving the nasal or oral cavities following exposure to freshwater. Genital involvement is exceedingly rare, particularly in children, and may present a diagnostic challenge when manifesting as unexplained vaginal bleeding.

Case Presentation:

We report a case of a four-year-old Pakistani girl who presented with painless vaginal bleeding occurring 24 hours after exposure to stagnant freshwater during the monsoon season. Clinical examination, laboratory tests, and pelvic ultrasonography revealed no abnormalities. Owing to persistent bleeding, vaginoscopy was performed under general anesthesia. Saline irrigation revealed a live leech within the vaginal canal,which exited spontaneously and was removed. Bleeding resolved completely, and the child remained asymptomatic on follow-up.

Conclusion:

This case emphasizes the need to consider leech infestation in the differential diagnosis of pediatric vaginal bleeding following freshwater exposure.