Female leech bite

　　1. Etiology

　　Because when swimming or bathing in the river, leeches existing in the river adhere to the vulva or vagina, and while feeding on blood, they also secrete toxins, leading to the disease caused by blood loss and allergic reactions.

　　2. Pathogenesis

　　The leech is hermaphroditic, resembling a earthworm, with a brown or brown-black color, turning to reddish-brown after feeding on blood. It has over a hundred flattened segments and has suckers in front and behind the wheel-like part. During feeding, it uses its body's suckers to tightly adhere to the surface of the human skin and mucous membranes, damaging blood vessels to cause bleeding. When the leech adheres to the human body, its salivary glands can produce and release a unique secretion called hirudin and substances that dilate blood vessels, causing skin and systemic reactions. Hirudin has anticoagulant effects, making it difficult for blood to clot. Research has shown that although hirudin cannot destroy the coagulation function of platelets, it can inhibit the production of thrombin and reduce the generation of coagulation substances, resulting in a longer blood coagulation time. Therefore, when feeding, the blood that oozes locally will not coagulate quickly, leading to continuous local bleeding. The secreted histamine-like substances can cause allergic reactions in allergic individuals, even anaphylactic shock.

　　Bleeding may not stop at the site of the bite on the external genitals and vagina, but there is no local pain at the time. Generally, local pain is felt after the leech leaves.

　　The reproductive organs of children maintain a幼稚 state, the vagina is narrow and long, the mucosal epithelium is thin without folds, the vaginal acidity is low, and the resistance to infection is weak. When leeches bite, bacteria can invade, so the damaged vagina is also prone to external vulvitis and vaginal inflammation. Chronic cases can cause vaginal adhesions.

　　The main symptoms of leech bites in vaginal leeches are bleeding, with a triangular wound visible at the bite site. Due to the anticoagulant effect of the secretions from the leech's pharynx, bleeding is often severe, posing a mental threat to the person. When the external genitals and vaginal area are bitten, bleeding may not stop, but there is no local pain at the time. Generally, local pain is felt after the leech leaves. Many children may develop secondary infection, and when there is secondary infection, symptoms such as fever, headache, and general discomfort may occur. In allergic individuals, red spots, wheals, and even bullae and necrosis may be seen in severe cases.

　　This disease is more common in young girls and has an adverse effect on the physical and mental health of children, so it is necessary to strengthen the education of children in rural areas to prohibit swimming in ponds to prevent the occurrence of the disease.

　　1. The camping place should be chosen in a relatively dry area with few grass, not near lakes, rivers, or streams.

　　2. Wear long pants and pull the socks over the pants, tie the pants tightly, because leeches can penetrate through any hole.裸露的地方要涂抹防蚊剂或防虫油膏.

　　3. When crossing rivers or streams with leeches, the pants should be tightly tied, and after getting out of the water, check whether there are leeches attached.

　　4. Frequently check for leech bites on the body while resting, and remove them promptly if any are found.

　　5. Try to drink boiled water and avoid drinking water with leeches. Small larvae are not easy to detect and can寄生 in the respiratory tract, esophagus, and urinary tract after being ingested.

　　Patients with vaginal leeches should undergo the following examinations: blood tests, platelet count, bleeding and coagulation time. When secondary infection occurs, the white blood cell count increases. Vaginal secretion examination, colposcopy.

　　1. Avoid spicy foods

　　Excessive consumption of spicy foods (such as chili, ginger, scallion, garlic, etc.) can easily lead to dryness and heat, causing internal organs to accumulate heat and toxicity, resulting in symptoms such as swollen and painful gums, canker sores on the tongue, short and dark urine, burning sensation at the anus, and itching and pain in the perineum, thereby aggravating the symptoms of the disease.

　　2. Avoid seafood that causes heat

　　Seafood such as mandarin fish, yellow croaker, hairtail fish, black croaker, shrimp, crab, etc., can promote damp-heat, and eating them can worsen vulvar pruritus, which is not conducive to the regression of inflammation, so they should be avoided.

　　3. Avoid sweet and greasy foods

　　Fatty foods such as lard, pork fat, butter, beef fat, sheep fat, etc., and high-sugar foods such as chocolate, candy, sweet pastries, cream cakes, etc., have the effect of promoting dampness and heat, which can increase the secretion of leukorrhea and affect the effectiveness of treatment.

　　4. Smoking and alcohol

　　Smoking can worsen the disease, as nicotine in tobacco can weaken the binding force of arterial blood and oxygen, and alcohol can enhance damp-heat, so it should be avoided. Similarly, alcohol-containing drinks such as rice wine and medicinal wine are not suitable for drinking.

　　5. Pay attention to diet and nutrition

　　It is advisable to eat more fresh vegetables and fruits to keep the bowels smooth; it is advisable to drink more water; prevent urinary tract infections.

　　1. Treatment

　　1. Application method:必要时可用2％普鲁卡因加1％肾上腺素浸湿棉花球塞入阴道内，此时较易去除蚂蟥虫体。可用10％高渗盐水500～1000ml冲洗阴道，可使蚂蟥很快失去活动能力而脱离阴道壁。

　　2. Prevention of infection After the worms are removed, antibiotics should be used to prevent infection.

　　3. Rapid hemostasis generally uses concentrated salt water irrigation for rapid hemostasis, followed by local packing with iodophor gauze after rinsing, and removal after 4 hours. For individuals who are ineffective, careful exposure of the vagina under anesthesia can be made to find the bleeding site, and hemostasis can be achieved by electrocoagulation or suture. There are also successful reports of hemostasis using a disposable double-lumen catheter water balloon for refractory hemorrhage.

　　4. In addition to surgery, blood transfusion, fluid replacement, and hemostatic drugs such as aminomethylbenzoic acid (hemostatic acid) should be considered. In severe cases, antitetanus prophylaxis should be administered.

　　5. Antihistamines should be used for allergic体质 individuals for antiallergic treatment.

　　6. Emotions should be stabilized, and psychological treatment should be carried out according to the patient's character and the cause of the disease to avoid leaving psychological shadows.

　　2. Prognosis

　　Wounds treated in a timely manner can heal in time. Generally, there are no adverse outcomes. Long-term disease can cause vaginal adhesions.