American Society of Hirudotherapy

Aeromonas hydrophila infection complicating digital replantation and revascularization

Case report published in J Hand Surg Am (1989)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportSafety & Infection ControlLowen RM et al. · J Hand Surg Am, 1989

Abstract

Two cases of thumb replantation and one of finger revascularization complicated by Aeromonas hydrophila infection are reported. Two digits were lost because of infection in soft tissue and osteomyelitis. One thumb had extensive necrosis. In all cases the infection was difficult to eradicate, probably because of ischemia. All three patients sustained their injuries while cutting meat or fish. These infection sources have not been previously reported. Note is made of Aeromonas hydrophila in medicinal leeches that are used in microvascular surgery and the potential for iatrogenic infection.

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

Publication typeCase ReportsJournal ArticleReview
Indexed MeSH termsAccidents, OccupationalAdultAeromonasAmputation, TraumaticBacterial InfectionsHumansMaleReplantationSurgical Wound InfectionThumb

Summary

Three cases of thumb/finger replantation complicated by Aeromonas hydrophila infection; two digits lost; Aeromonas in medicinal leeches noted as potential iatrogenic infection source.

Why This Matters for Hirudotherapy

This article reports three cases of Aeromonas hydrophila infection complicating digital replantation and revascularization, resulting in the loss of two digits and extensive necrosis of one thumb. All three patients sustained injuries while cutting meat or fish—sources not previously reported—and the infections were difficult to eradicate, likely due to tissue ischemia. The authors specifically note the presence of A. hydrophila in medicinal leeches that are used in microvascular surgery and the potential for iatrogenic infection. This is relevant to hirudotherapy safety as it highlights the pathogenic potential of A. hydrophila in the context of medicinal leech use. However, the reported infections in these cases arose from occupational trauma rather than leech application; the leech connection is noted only as a contextual caution, and the report involves a small number of cases without controls.

Citation

Aeromonas hydrophila infection complicating digital replantation and revascularization.

Lowen RM et al. · J Hand Surg Am, 1989

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.