Rare living hypopharyngeal foreign body

Theromyzon maculosum (Rathke, 1862) as a vector of potentially pathogenic fungi in aquatic ecosystems

The aim of the study was to check the integument and alimentary tract of Theromyzon for the occurrence of fungi. Moreover, the mycological purity of water sources from which leeches were collected was analyzed. The potential role of the duck leech Theromyzon maculosum in transmitting pathogenic fungi has not been studied until now. Mycological analyses were performed according to the procedure approved in mycological diagnostic laboratories, using classical diagnostic methods (macro- and microcultures, microscopic observations). In total, 22 species of yeasts were detected. The specimens belong to eight genera: Candida, Citeromyces, Debaryomyces, Kluyveromyces, Lodderomyces, Pichia, Saccharomyces and Saccharomycodes. Overall, 18 species of fungi were isolated from leeches Theromyzon maculosum, including seven species from the integument and 11 species from the gastrointestinal system. Among fungi isolated from body integument, fungi of the genus Candida were dominant, whereas in the gastrointestinal system, the genus Saccharomyces dominated. From the river waters, nine fungi species were isolated, and yeasts of the genera Candida and Kluyveromyces dominated. Isolation of the same species of microfungi from the integument of leeches and the river water suggests that Theromyzon maculosum may be a potential vector of pathogenic yeasts for vertebrates living in the same ecosystems and for humans.

A Rare Case of Hemoptysis Caused by a Laryngeal Leech

The larynx is an uncommon location for live foreign bodies. The leech can reach the glottis during consumption of contaminated water but is usually expelled by an effective cough reflex. Patients present with hoarseness and dysphagia and occasionally with dyspnea or hemoptysis. Endoscopically, a mobile mass is usually noted in the supraglottic area. We present a rare case of a laryngeal leech in a 62-year-old-male farmer who lives in a rural area. The leech was removed successfully with direct laryngoscopy under general anesthesia.

Negative suction approach to remove living leeches from the nasal cavity

OBJECTIVE

To explore a method for removing a living leech from the nasal cavity.

MATERIALS AND METHODS

A total of 5 patients with nasal leech were examined. Nasal endoscopy revealed the presence of a wriggling leech in the nasal cavities of each of these patients. A negative suction tube with an inner diameter of 3 mm and a negative pressure of 30-40 kp was used to remove these leeches. In each case, this suction tube was aimed at the free end of the leech, and the leech was gradually and slowly sucked into the tube. The suckers of the removed leeches were examined to ensure that no leech fragments remained within each patient.

RESULTS

In all 5 cases, the intact leech was successfully removed. No surgical complications occurred.

CONCLUSIONS

The negative suction method can successfully remove nasal leeches.

Evidenced-based management of haemoptysis by otolaryngologists

BACKGROUND

Haemoptysis is an uncommon presenting symptom to the ENT clinic and ward, but has potentially sinister aetiology. This article aims to provide a systematic and evidence-based method of managing patients with haemoptysis.

METHODS

The data in this article are based on a literature search performed using PubMed in August 2013. The keywords used included 'haemoptysis' in combination with 'otolaryngology', 'ENT', 'head & neck', 'diagnosis', 'management', 'investigations' and 'treatment'.

RESULTS

The majority of published literature on the subject is level IV evidence. However, this can guide ENT specialists in assessing, investigating and managing presentations of haemoptysis.

CONCLUSION

Understanding the different causes of haemoptysis is important for the otolaryngologist. The main concern is the detection of a malignant lesion in the upper aerodigestive tract or tracheobronchial tree. A thorough history and systematic examination can aid diagnosis.

Leeches--the good, the bad and the wiggly

Leeches have been making a remarkable come-back in medical practice in recent years, particularly in reconstructive surgery. This paper opens with a brief review of the historical aspects of the medicinal use of leeches and their recent renaissance in modern medical practice. We then embark on a journey through the murky waters of leech infestation and the potentially life-threatening complications arising from close encounters with these extraordinary creatures. Finally, we get to grips with the tricky issue of safely apprehending and removing uninvited hangers-on.