Medico-Legal Implications of Leech Bites in Children

Abstract

Introduction Vaginal bleeding after first week of life but before menarche is always abnormal and need diagnostic evaluation. This may be the first evidence of sexual abuse. False allegations and suspicion among guardians may lead to serious consequences on the child as well as on suspects. . Case history An eight months old child living in a rubber estate presented with sudden onset vaginal bleeding for two days. Bleeding disorders were excluded and was referred to a JMO to exclude sexual abuse. Medicolegal examination done on the third day after the incident revealed 1.2 cm x l cm bleb of hemorrhage on labia minora. An underlying isolated 0.5cm abrasion appeared with active bleeding. There was no past history of similar episodes. Grandmother named few suspects and alleged sexual abuse. Later, mother mentioned that a leach was found in the room sometime after the incident.

Conclusions Unusual vaginal bleeding in children should be investigated thoroughly to achieve justice, to exclude false allegations and to protect children and guardians from stigma. In victims with itchy lesions, clinicians should keep in mind of leech bite. Forensic pathologists must be aware of fauna of his working area because they could cause medico-legally significant injuries.