Vaginal bleeding in 6 years old young female: diagnostic challenge

A 6 year old young girl was referred to Mendefera (Zoba Debub Referral) Hospital with vaginal bleeding of 4 days duration. She had a history of swimming in a river prior to the incident. An aquatic leech bloated with blood detached from the vagina after 100 milliliters of normal saline flushing into the vagina. The patient was discharged on the second day postremoval of the leech, on amoxicillin for 7 days and follow up. Health professionals must be aware of the possibility of leech bites in the vagina as the differential diagnosis for abnormal vaginal bleeding, especially in places where leech infestation is common, a high index of suspicion is of great help to make an early diagnosis and treatment.