{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T14:52:55Z","timestamp":1781275975920,"version":"3.54.1"},"reference-count":14,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,2]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Leeches, which are bloodsucking annelids widely distributed in natural environments globally, can cause hirudiniasis when they invade the human body. The most common site of infestation in humans is the nasopharynx, although they can also infiltrate less common sites, such as the trachea, esophagus, and urinary and reproductive tracts. We present the case of a 47-year-old male patient with a persistent cough for 2 months associated with hemoptysis and intermittent hoarseness for 1 month. Nasopharyngoscopy revealed an actively moving worm located above the vocal cords. Subsequently, under intravenous anesthesia, we removed the live worm through bronchoscopy, and it was identified as a leech. In areas where hirudiniasis is endemic, the possibility of tracheal leech infestation should be considered in patients presenting with chronic cough, hemoptysis, and hoarseness. Furthermore, it is crucial to take necessary precautions during outdoor activities to prevent the occurrence of hirudiniasis.<\/jats:p>","DOI":"10.4269\/ajtmh.24-0716","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T16:23:13Z","timestamp":1739290993000},"page":"928-930","source":"Crossref","is-referenced-by-count":1,"title":["Tracheal Hirudiniasis Induced by Ingestion of Unboiled Mountain Spring Water"],"prefix":"10.4269","volume":"112","author":[{"given":"Lei","family":"Ni","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;"},{"name":"Department of Respiratory and Critical Care Medicine, People\u2019s Hospital of Mojiang Hani Autonomous County, Yunnan, China;"},{"name":"Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun Ce","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, People\u2019s Hospital of Mojiang Hani Autonomous County, Yunnan, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Jinshan Branch of Shanghai Sixth People\u2019s Hospital, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zi Xuan","family":"Hua","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;"},{"name":"Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing Yun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;"},{"name":"Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Wilderness Environ Med","first-page":"355","article-title":"A comprehensive review of hirudiniasis: From historic uses of leeches to modern treatments of their bites","volume":"28","author":"Joslin","year":"2017"},{"key":"b2","series-title":"Eur J Pediatr","first-page":"39","article-title":"Leech endoparasitism: Report of a case and review of the literature","volume":"168","author":"Montazeri","year":"2009"},{"key":"b3","series-title":"Indian J Otolaryngol Head Neck Surg","first-page":"42","article-title":"Epistaxis due to leech infestation in nose: A report of six cases and review of literature","volume":"68","author":"Dutta","year":"2016"},{"key":"b4","series-title":"Chest","first-page":"481","article-title":"Alive in the airways: Live endobronchial foreign bodies","volume":"151","author":"Ali","year":"2017"},{"key":"b5","series-title":"Future Sci OA","first-page":"FSO802","article-title":"Esophageal hirudiniasis: An unusual cause of upper gastrointestinal bleeding","volume":"8","author":"Mahmoudi","year":"2022"},{"key":"b6","series-title":"J Coll Physicians Surg Pak","first-page":"156","article-title":"Reach the leech: An unusual cause of hematuria","volume":"26","author":"Mansoor","year":"2016"},{"key":"b7","series-title":"Wilderness Environ Med","first-page":"579","article-title":"A rare case of vaginal bleeding in a child due to a leech bite and review of the literature","volume":"26","author":"Karunaratne","year":"2015"},{"key":"b8","series-title":"Clin Respir J","first-page":"581","article-title":"Bronchoscopic removal of a leech from the trachea by cryotherapy","volume":"16","author":"Li","year":"2022"},{"key":"b9","series-title":"Int J Clin Exp Med","first-page":"3599","article-title":"A rare case report of tracheal leech infestation in a 40-year-old woman","volume":"7","author":"Zhang","year":"2014"},{"key":"b10","series-title":"Case Rep Pediatr","first-page":"2372686","article-title":"Bronchial leech infestation in a 15-year-old female","volume":"2016","author":"Moslehi","year":"2016"},{"key":"b11","series-title":"Ecol Evol","first-page":"918","article-title":"Diversity and selective pressures of anticoagulants in three medicinal leeches (Hirudinida: Hirudinidae, Macrobdellidae)","volume":"3","author":"Kvist","year":"2013"},{"key":"b12","series-title":"FEBS J","first-page":"1481","article-title":"The leech product saratin is a potent inhibitor of platelet integrin alpha2beta1 and von Willebrand factor binding to collagen","volume":"274","author":"White","year":"2007"},{"key":"b13","series-title":"Integr Med Res","first-page":"337","article-title":"Medicinal leech therapy\u2014An overall perspective","volume":"6","author":"Sig","year":"2017"},{"key":"b14","series-title":"Naturwissenschaften","first-page":"995","article-title":"Small bite, large impact\u2014Saliva and salivary molecules in the medicinal leech, Hirudo medicinalis","volume":"98","author":"Hildebrandt","year":"2011"}],"container-title":["The American Journal of Tropical Medicine and 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