American Society of Hirudotherapy

Aeromonas hydrophila infections following clinical use of medicinal leeches: a review of published cases

Review published in Blood coagulation & fibrinolysis (1991)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewSafety & Infection ControlLineaweaver WC et al. · Blood coagulation & fibrinolysis, 1991

Abstract

Ten Aeromonas hydrophila infections following postsurgical leech applications have been reported. These cases indicate that postsurgical wounds and damaged tissue can provide entry for either acute or delayed A. hydrophila infection. These infections can range from localized cellulitis to progressive myonecrosis and sepsis. These infections may occur with measurable frequency in groups of patients exposed to leeches. Based on this review, it is recommended that leeches be applied only to tissue with a reasonably certain arterial supply; that patients receive antibiotics against A. hydrophila prior to leech administration; and that consideration be given to prolonged antibiotic administration to patients discharged home with open wounds or questionably viable tissue after leech administration.

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

Publication typeJournal ArticleReview
Indexed MeSH termsAeromonasAnimalsAnti-Bacterial AgentsBites and StingsGram-Negative Bacterial InfectionsHumansIncidenceLeechesPostoperative ComplicationsPremedication

Summary

Aeromonas hydrophila infections following clinical use of medicinal leeches: a review of published cases.

Why This Matters for Hirudotherapy

This review examined ten reported cases of Aeromonas hydrophila infections following postsurgical leech applications. The abstract describes infections ranging from localized cellulitis to progressive myonecrosis and sepsis, and recommends that leeches be applied only to tissue with a reasonably certain arterial supply, that patients receive antibiotics against A. hydrophila prior to leech administration, and that prolonged antibiotic administration be considered for patients discharged with open wounds or questionably viable tissue. This article is relevant to the American Society of Hirudotherapy as it addresses clinical safety considerations and infectious complications associated with medical leeching, directly informing risk management in postsurgical leech therapy.

Citation

Aeromonas hydrophila infections following clinical use of medicinal leeches: a review of published cases

Lineaweaver WC et al. · Blood coagulation & fibrinolysis, 1991

DOIPubMed

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.