American Society of Hirudotherapy

Leech-borne Serratia marcescens infection following complex hand injury.

Case report published in British journal of plastic surgery (1998)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportSafety & Infection ControlPereira et al. · British journal of plastic surgery, 1998

Abstract

Leeches are commonly used in the postoperative course of plastic surgical operations where there is venous congestion in a pedicled or free flap. They provide a temporary relief to venous engorgement whilst venous drainage is re-established. It is known that leeches can carry Aeromonas hydrophila infection, and a second or third generation cephalosporin antibiotic has traditionally been given as prophylaxis against infection. We report a new observation that leeches can carry Serratia marcescens and give rise to clinically significant infection. The implication for prophylaxis and treatment of leech-associated cellulitis is discussed.

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

Publication typeCase ReportsJournal Article
Indexed MeSH termsAdultAnimalsFemaleFinger InjuriesHumansLeechesPhlebotomyReplantationSerratia InfectionsSerratia marcescens

Summary

Leeches are commonly used in the postoperative course of plastic surgical operations where there is venous congestion in a pedicled or free flap. They provide a temporary relief to venous engorgement whilst venous drainage is re-established.

Why This Matters for Hirudotherapy

This case report documents a new observation that medicinal leeches can carry Serratia marcescens and give rise to clinically significant infection. The abstract describes leeches as commonly used in plastic surgical operations where there is venous congestion in a pedicled or free flap, notes that Aeromonas hydrophila is the traditionally recognized leech-associated pathogen with second- or third-generation cephalosporin prophylaxis as standard, and discusses implications for prophylaxis and treatment of leech-associated cellulitis. This article is directly relevant to ASH's domain as it concerns a safety issue in clinical leech use—bacterial transmission risk—and challenges existing prophylaxis assumptions. However, it is a case report, so its findings about Serratia as a leech-borne pathogen are limited in scope and cannot establish prevalence or comprehensive recommendations.

Citation

Leech-borne Serratia marcescens infection following complex hand injury.

Pereira et al. · British journal of plastic surgery, 1998

DOI

Added to ASH library: May 28, 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.