American Society of Hirudotherapy

Ciprofloxacin-resistant Aeromonas hydrophila infection following leech therapy: a case report and review of the literature

Case report published in Journal of Plastic, Reconstructive & Aesthetic Surgery (2013)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportSafety & Infection ControlPatel KM, Svestka M, Sinkin J, Ruff P · Journal of plastic, reconstructive & aesthetic surgery, 2013

Abstract

Compromised flap perfusion can lead to the use of leech therapy to aid in flap salvage. Aeromonas hydrophila, a symbiont of the leech, is a well-known bacterial pathogen that has the potential to cause infection in patients receiving leech therapy. Ciprofloxacin is commonly regarded as the antibiotic of choice for prophylaxis against this pathogen. We present patient who underwent leech therapy during salvage attempts for a venous congested flap. A resultant infection developed despite being on appropriate antibiotics. Culture sensitivities indicated that A. hydrophila was resistant to ciprofloxacin.

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

Publication typeCase ReportsJournal ArticleReview
Indexed MeSH termsAeromonas hydrophilaAnti-Bacterial AgentsAntibiotic ProphylaxisAztreonamCiprofloxacinDrug Resistance, BacterialFemaleGram-Negative Bacterial InfectionsHumansLeechingMiddle Aged

Summary

Patient developed ciprofloxacin-resistant Aeromonas hydrophila infection during leech salvage of a venous-congested flap despite appropriate prophylaxis, with literature review of leech-associated infections.

Why This Matters for Hirudotherapy

This case report describes a patient who underwent leech therapy during salvage attempts for a venous congested flap and subsequently developed an Aeromonas hydrophila infection resistant to ciprofloxacin, despite receiving what was considered appropriate antibiotic prophylaxis. Culture sensitivities confirmed that the A. hydrophila isolate was resistant to ciprofloxacin, the agent commonly regarded as the antibiotic of choice for prophylaxis against this leech symbiont. This finding is relevant to hirudotherapy practice, as it documents a clinical case in which ciprofloxacin prophylaxis did not prevent infection by a resistant strain of this recognized leech-associated pathogen. However, the evidence is limited to a single case report, and no broader conclusions about resistance prevalence or alternative prophylactic regimens can be drawn from this report alone.

Citation

Ciprofloxacin-resistant Aeromonas hydrophila infection following leech therapy: a case report and review of the literature.

Patel KM, Svestka M, Sinkin J, Ruff P · Journal of plastic, reconstructive & aesthetic surgery, 2013

DOI

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.