an unusual cause of dysphonia with hemoptysis: a laryngeal live leech

introduction: foreign bodies in the upper airway are one of the most challenging otolaryngology emergencies and have various presentations depending on their physical properties and location. leeches are blood-sucking hermaphroditic worms that vary in color, length, and shape. they usually reside in fresh-water streams and lakes. when rural untreated water is drunk, leeches may localize in the nose, pharynx, and esophagus, or rarely in the larynx. case report: this case is a man who was referred to our otolaryngology clinic with a complaint of hemoptysis and mild respiratory distress. the patient’s symptoms were all relieved post operatively and he was discharged on the second day following the procedure.  conclusion: leeches should be suspected as an airway foreign body in patients with a recent history of drinking stream water.