American Society of Hirudotherapy

Leech related Aeromonas complex infection after reconstruction with a microvascular forearm flap

Case report published in J Maxillofac Oral Surg (2016)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportSafety & Infection ControlAntimicrobial ResistanceBeger B et al. · Journal of maxillofacial and oral surgery, 2016

Abstract

Medical leeches (Hirudo medicinalis) in plastic and reconstructive surgery are often used for the treatment of vascular failure after microvascular surgery. Leeches are a reservoir for bacteria of the Aeromonas group that help digesting the blood meal. In some cases these bacteria are able to cause severe wound infections that can lead to loss of tissue transplants. We report about a patient with a common microvascular forearm flap after resection of an oral squamous cell carcinoma which got infected by Aeromonas spp. after treatment with medical leeches. Most of these species are resistant for common antibiotic treatment after surgery. This report shows the importance of an early concomitant antibiotic prophylaxis in the treatment of venous congestion with medical leeches.

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

Publication typeCase ReportsJournal Article

Summary

Patient with microvascular forearm flap after oral SCC resection developed Aeromonas spp infection resistant to common antibiotics after leech therapy.

Why This Matters for Hirudotherapy

This case report describes a patient with a microvascular forearm flap following oral squamous cell carcinoma resection who developed an Aeromonas spp. wound infection after treatment with medicinal leeches (Hirudo medicinalis) for vascular failure. The report emphasizes that many Aeromonas species are resistant to common postoperative antibiotic regimens and stresses the importance of early concomitant antibiotic prophylaxis when using medical leeches for venous congestion. This is directly relevant to ASH's domain, reinforcing the infectious risk associated with hirudotherapy and the need for prophylactic coverage. The limitation is that this is a single case report with limited microbiological detail in the abstract and no specified species identification or resistance profiling.

Citation

Leech related Aeromonas complex infection after reconstruction with a microvascular forearm flap.

Beger B et al. · Journal of maxillofacial and oral surgery, 2016

DOI

Added to ASH library: May 27, 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.