Abstract
Only one bleeding point is typically seen in the local mucosa in most cases of nasal bleeding. We report here a rare epistaxis case suspected of multiple bleeding points on unilateral nasal cavity. A 64-year-old male had a one-week history of chance left-sided epistaxis. Multiple mucosal eruptions were seen on the inferior and middle turbinates and nasal septum of the left nasal mucosae. A dark brown mass was recognized near the frontal recess and removed. This mass was determined to be a live nasal leech. This patient had an history of leech exposure three months earlier while bathing in natural hot spring. Patients with a nasal foreign body usually have symptoms of foul-smelling purulent secretion and nasal stiffness with mucosal swelling. These symptoms are the result of rejection reactions by neutrophills against the foreign body. However, this reported case had no such symptom. This finding was supported that a live leech moves around the nasal cavity to escape human immune reactions.
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