Aeromonas septicemia after medicinal leech use following replantation of severed digits
Case report published in American Journal of Critical Care (2009)
Abstract
Medicinal leeches are used to control venous congestion. Aeromonas in the leech gut are essential for digestion of blood. This case report describes a patient who had Aeromonas bacteremia develop after leeching. He had an injury to his hand that required replantation of his thumb. Following the surgery, leech therapy was started with ampicillin-sulbactam prophylaxis. Sepsis developed. Blood cultures were positive for Aeromonas that were resistant to ampicillin-sulbactam. The antibiotic was changed to ciprofloxacin on the basis of the sensitivity profile of the organisms. Cultures from the leech bathwater confirmed it as the source of the Aeromonas. Clinicians who use leech therapy must be aware that leeches can harbor Aeromonas species resistant to accepted prophylactic antibiotics and that sepsis may occur.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Patient developed Aeromonas septicemia after leech therapy for thumb replantation despite ampicillin-sulbactam prophylaxis; cultures from leech bathwater confirmed it as the infection source, antibiotic changed to ciprofloxacin based on sensitivity.
Why This Matters for Hirudotherapy
This case report describes a patient who developed Aeromonas bacteremia and sepsis after medicinal leech therapy following thumb replantation; despite ampicillin-sulbactam prophylaxis, blood cultures grew Aeromonas resistant to that agent, the regimen was switched to ciprofloxacin per sensitivities, and leech bathwater cultures confirmed the bath as the source. It directly documents the core infectious hazard of hirudotherapy: Aeromonas in the leech gut is essential for blood digestion, so the organism that makes leeches therapeutically useful is also the one that can cause resistant infection. As a single case report it establishes a hazard and a plausible source, not its frequency, and the authors' practical lesson is that clinicians must anticipate Aeromonas resistant to the usual prophylactic antibiotics.
Citation
Aeromonas septicemia after medicinal leech use following replantation of severed digits.
Levine SM, Frangos SG, Hanna B, Colen K, Levine JP · American journal of critical care, 2009
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