American Society of Hirudotherapy

[Infections Associated with Treatment with Hirudo medicinalis - Report of Two Cases and Review of the Literature]

Review article published in Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V... (2015)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportClinical TrialsSafety & Infection ControlReese K et al. · Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V..., 2015

Abstract

Medicinal leeches are well-established for promoting venous drainage in transplants/flaps and analgesia in osteoarthritis. Although medicinal leeches are bred and kept under controlled conditions, they are colonised by a genuine species-specific bacterial flora. Therapeutic application of leeches implies skin penetration carrying an a priori risk of infection. We report 2 cases with different indications for medicinal leech therapy. In both cases wound infection occurred in close temporal and spatial correlation or with evidence of a leech-associated germ that could be treated successfully. An unclarified complication rate warrants strict indications for the application of medicinal leeches. Preventive measures are currently tested.

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

Publication typeCase ReportsEnglish AbstractJournal ArticleReview
Indexed MeSH termsAdultAeromonasAgedAnimalsAnkle JointAnti-Bacterial AgentsCombined Modality TherapyCompartment SyndromesContusionsErysipelasFemaleGram-Negative Bacterial Infections

Summary

Medicinal leeches are well-established for promoting venous drainage in transplants/flaps and analgesia in osteoarthritis. Although medicinal leeches are bred and kept under controlled conditions, they are colonised by a genuine species-specific bacterial flora.

Why This Matters for Hirudotherapy

This report describes two cases of wound infection occurring in close temporal and spatial correlation with medicinal leech therapy, where infections were linked to leech-associated bacteria and were successfully treated. The work addresses a clinically important safety dimension of hirudotherapy: although medicinal leeches are bred under controlled conditions, they harbor a genuine species-specific bacterial flora, and therapeutic application inherently involves skin penetration that carries an a priori infection risk. For ASH's domain, this underscores the need for awareness of potential infectious complications and supports the authors' call for strict therapeutic indications and development of preventive measures. However, because the findings rest on only two clinical cases, the overall complication rate remains unclarified, and no quantitative data on infection incidence or validated preventive protocols are presented.

Citation

[Infections Associated with Treatment with Hirudo medicinalis - Report of Two Cases and Review of the Literature].

Reese K et al. · Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V..., 2015

DOI

Added to ASH library: March 18, 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.