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A 31-year-old man complained of intermittent wheeze, dyspnoea and hoarse voice for 2 months. He was diagnosed with asthma and prescribed inhaled corticosteroid by the general practitioner. However, his symptoms persisted despite compliance to inhaler therapy. He was a non-smoker, worked as a logger and remembered quenching his thirst at a nearby river prior to his symptoms. Physical examination revealed a well-nourished man with audible wheeze, normal vital parameters and saturating 96% on room air. Chest radiograph (CXR) was unremarkable. Flexible bronchoscopy performed for hoarse voice revealed a leech straddling the vocal cords. It was attached to the …
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