Rickettsia japonica infection after land leech bite, Japan

This case report describes an 81-year-old man in central Japan who developed Rickettsia japonica infection (fever, rash, eschar) with symptom onset eight days after a land leech bite and no evidence of a tick bite. The authors propose the land leech as a potential vector of R. japonica. This relates to ASH's domain only as documentation of an infectious complication following leech exposure, contributing to awareness of risks associated with leech bites. The case involves a wild land leech bite, not therapeutic hirudotherapy, and does not address the medicinal leech secretome, anticoagulant activity, or controlled leech application. It is a single case report establishing only a possible vector relationship.