American Society of Hirudotherapy

Aeromonas hydrophila infection associated with the use of medicinal leeches

Case report published in Journal of Clinical Microbiology (1989)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportSafety & Infection ControlSnower DP, Ruef C, Kuritza AP, Edberg SC · Journal of clinical microbiology, 1989

Abstract

The use of medicinal leeches (Hiruda medicinalis) is becoming more common after plastic surgery to control venous congestion of skin grafts. We describe a patient with Aeromonas hydrophila infection whose graft was treated with medicinal leeches. The infection required systemic antibiotic therapy. A. hydrophila is the predominant bacterial flora in the gut of the leech, where it plays an essential role for the animal in the digestion of blood. The potential for A. hydrophila wound infection, and appropriate antibiotic prophylaxis of the leech or patient, should be considered when medicinal leeches are used.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeCase ReportsJournal Article
Indexed MeSH termsAeromonasAnimalsBacterial InfectionsDisease VectorsFemaleHumansLeechesMiddle AgedSkin TransplantationWound Infection

Summary

Seminal early case report of Aeromonas hydrophila infection in a skin graft patient treated with medicinal leeches, establishing the historical baseline for leech-borne infection literature.

Why This Matters for Hirudotherapy

This case report describes a patient who developed Aeromonas hydrophila infection after medicinal leech (Hiruda medicinalis) therapy for venous congestion of a skin graft following plastic surgery, with the infection requiring systemic antibiotic therapy. The abstract notes that A. hydrophila is the predominant bacterial flora in the leech gut, where it plays an essential role in blood digestion for the animal. This finding is directly relevant to hirudotherapy and ASH, as it highlights that the leech's symbiotic gut flora can introduce clinically significant wound infections, underscoring the importance of considering appropriate antibiotic prophylaxis of the leech or patient during medicinal leech therapy. The key limitation is that this is a single case report—it raises appropriate awareness of infectious complications but cannot establish the incidence of such infections or guide prophylaxis decisions without larger studies.

Citation

Aeromonas hydrophila infection associated with the use of medicinal leeches.

Snower DP, Ruef C, Kuritza AP, Edberg SC · Journal of clinical microbiology, 1989

Added to ASH library: May 26, 2026 · Site last updated: June 18, 2026

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.