Hirudinea (leeches)
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Introduction
A class of worms with flat, segmented bodies, a sucker at the posterior end & often a smaller sucker at the anterior end.
Epidemiology
- hirudinea are predatory on invertebrate tissues or feed on blood & tissue exudates of vertebrates.
- aquatic leeches (ubiquitous) that parasitize fish, frogs & turtles readily attach to human & suck blood
- several species of aquatic leeches in Africa, Asia & Southern Europe enter through the mouth, nose & genito- urinary tract & attach to mucosal surfaces, including the esophagus & trachea
Pathology
- hirudinin, an anticoagulant secreted by the leech, causes continued bleeding after the leech has fallen off
- healing of the wound is slow
- bacterial infections are NOT uncommon
Clinical manifestations
- attachment is generally painless
- bleeding from mucosally attached leeches may be intense
Management
- leeches are removed by steady, gentle traction
- removal is hastened by application of alcohol, salt, vinegar or a flame to the leech
- internal (mucosal) attachments