Beyond the epistaxis: voluntary nasal leech () infestation revealed the leech behaviours and the host symptoms through the parasitic period.

Dinobdella ferox is the most reported and studied leech species parasitizing mammalian mucus membranes. However, our knowledge of D. ferox during parasitizing and its effects on hosts has remained limited. To investigate the behaviour of D. ferox in the parasitic period and the subsequent host symptoms, the author was infested voluntarily with three juvenile leeches under regularly-conducted examinations of complete blood count (CBC) and nasal endoscopy (NE). After the first head protrusion of the parasitizing leech at the host nostril, the occurrence of bleeding-related symptoms decreased and ceased completely weeks before the end of the parasitic period. Negligible impacts of the parasitizing leech on the host were shown by CBCs, and a parasitizing leech was able to hide from NE despite being so large it at times protrudes out of the host nostril. Finally, parasitizing D. ferox were coaxed to emerge at the nostril by water only after their first head protrusion, indicating that non-invasive removal of parasitizing D. ferox before head protrusion might be difficult. Through the voluntary infestation, the full documentation of behaviours of D. ferox in the parasitic period and host symptoms shown in this study will promote better diagnoses and treatments of nasal leech infestation.