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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Drs Batra and Holinger¹ have written a comprehensive review about the etiology and management of hemoptysis in the pediatric population.

Acute lower respiratory tract infection was found in 40% of their cases and the etiology was unknown in 21% of cases.

One potential cause of hemoptysis in childhood that has not been addressed in their review, yet has been reported repeatedly in literature is leech infestation. Leeches can reach the upper or lower airway when water is ingested directly from an infected lake or river. Depending upon the anatomic attachment of the leech, it then causes the symptoms of stridor, cough, hemoptysis, or cyanosis. In essence, it is a live foreign body.

In most cases the upper airway is involved and diagnosis can be obtained by direct laryngoscopy, but when the lower respiratory tract is the site of attachment, it becomes a diagnostic challenge.

Although leech infestation occurs mostly in . . . [Full Text of this Article]