{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T01:46:27Z","timestamp":1771033587615,"version":"3.50.1"},"reference-count":13,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","license":[{"start":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T00:00:00Z","timestamp":1717545600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,5]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>A 2-year-old boy presented to Kapsowar Mission Hospital in Kenya with a history of general tiredness associated with mild, unilateral epistaxis and one episode of hematemesis. On admission, he had a hemoglobin value of 3.5\u2009g\/dL, with a white cell count of 20.6 \u00d7 10<jats:sup>9<\/jats:sup>\/L. The child was examined by the physician on call, with no source of bleeding found. Later that day, after a local physician noted that the presentation could be due to an unrecognized leech infestation, a deep examination of the oropharynx was performed with a laryngoscope and revealed a leech attached deep in the oropharynx. The anesthetist visualized the leech with a laryngoscope and removed it with Magill forceps. After the procedure and blood transfusion, the child\u2019s hemoglobin level improved to 10.4\u2009g\/dL, and on the following day, the child was much improved in energy and was playing outside. He was discharged home on iron supplements and made a full recovery.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0677","type":"journal-article","created":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T15:15:46Z","timestamp":1712070946000},"page":"1261-1262","source":"Crossref","is-referenced-by-count":2,"title":["Case Report: Profound Anemia in a 2-Year-Old Boy Associated with a Leech in the Oropharynx"],"prefix":"10.4269","volume":"110","author":[{"given":"Jerome","family":"Koleski","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Kapsowar Mission Hospital, Kapsowar, Kenya;"},{"name":"Department of Family and Community Medicine, University of Arizona, Tucson, Arizona;"},{"name":"Department of Family Medicine, Kabarak University, Nakuru, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amos","family":"Kipngetich Kurgat","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Kapsowar Mission Hospital, Kapsowar, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilie","family":"Tindal","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Kapsowar Mission Hospital, Kapsowar, Kenya;"},{"name":"Faculty of Medicine, University of Southampton, Southampton, United Kingdom;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenna","family":"Haugen","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Kapsowar Mission Hospital, Kapsowar, Kenya;"},{"name":"Department of Family Medicine, Stanton Territorial Hospital, Yellowknife, NT, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Thorp and Covich\u2019s Freshwater Invertebrates (Fourth Edition)","first-page":"509","author":"Verdonschot"},{"key":"b2","series-title":"J Craniofac Surg","first-page":"e119","article-title":"A rare cause of hemoptysis: Hypopharyngeal leech","volume":"32","author":"Aslan","year":"2021"},{"key":"b3","series-title":"J Travel Med","first-page":"taac089","article-title":"An unusual cause of hemoptysis and hoarseness due to live leech in the glottis: Case report","volume":"31","author":"Zou","year":"2022"},{"key":"b4","series-title":"Pediatr Hematol Oncol","first-page":"547","article-title":"Unexpected result in the etiological approaching to an anemic case: A leech infestation","volume":"20","author":"Demir\u00f6ren","year":"2003"},{"key":"b5","series-title":"Turkiye Parazitol Derg","first-page":"61","article-title":"A rare cause of hemoptysis: Oropharyngeal leech","volume":"44","author":"\u00c7\u0131ld\u0131r","year":"2020"},{"key":"b6","series-title":"Pak J Pathol","first-page":"42","article-title":"Leech infestation in oro-pharynx","volume":"17","author":"Butt","year":"2006"},{"key":"b7","series-title":"Arch Pediatr","first-page":"94","article-title":"Upper airway obstruction and hemoptysis due to a leech infestation in a child","volume":"23","author":"Draiss","year":"2016"},{"key":"b8","author":"Conley","year":"2021"},{"key":"b9","series-title":"Int J Pediatr Otorhinolaryngol","first-page":"853","article-title":"Nasal leech infestation in children: Comparison of two different innovative techniques","volume":"73","author":"Adhikari","year":"2009"},{"key":"b10","series-title":"Leech Nasopharynx J Med Cases","first-page":"71","article-title":"Rare cause of epistaxis, hemoptysis and anemia","volume":"1","author":"Iynen","year":"2010"},{"key":"b11","series-title":"Ann Trop Paediatr","first-page":"189","article-title":"Severe anaemia due to leech in the vagina","volume":"1","author":"Lepage","year":"1981"},{"key":"b12","series-title":"Ethiop J Health Sci","first-page":"377","article-title":"Vaginal leech infestation: A rare cause of hypovolumic shock in postmenopausal woman","volume":"25","author":"Tilahun","year":"2015"},{"key":"b13","series-title":"Southeast Asian J Trop Med Public Health","first-page":"319","article-title":"An unusual case of urethral hiriduniasis","volume":"39","author":"Ahmad","year":"2008"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/110\/6\/article-p1261.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/110\/6\/article-p1261.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/110\/6\/article-p1261.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T12:58:35Z","timestamp":1717592315000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/110\/6\/article-p1261.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,5]]},"references-count":13,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.23-0677","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,5]]}}}