American Society of Hirudotherapy

Wohlfahrtiimonas chitiniclastica Infections in two patients with osteomyelitis, China

Research article published in IDCases (2025)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportSafety & Infection ControlMeng et al. · IDCases, 2025

Abstract

This report presents two cases of human infection caused by Wohlfahrtiimonas chitiniclastica, a pathogen associated with chronic osteomyelitis and soft tissue infections. Case 1 involves a 75-year-old male with a long-standing, chronic wound following a right lower leg fracture, which worsened due to inappropriate treatments like "moxibustion" and leech therapy, leading to a severe infection. Despite initial antibiotic therapy with cefoxitin sodium, the infection progressed, resulting in amputation. Case 2 describes a patient with a refractory right plantar ulcer complicated by calcaneal osteomyelitis, who was treated with surgical debridement, followed by antimicrobial therapy based on bacterial culture and susceptibility testing. Both cases were associated with polymicrobial infections, including W. chitiniclastica, and required targeted antibiotic therapy. The diagnosis was confirmed using Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing, highlighting the importance of advanced diagnostic techniques. W. chitiniclastica is capable of causing life-threatening infections, including osteomyelitis and myiasis, particularly in patients with poor hygiene or chronic wounds. This study underscores the challenges in identifying emerging pathogens and the necessity for comprehensive diagnostic approaches, including whole-genome sequencing, to improve clinical outcomes and develop effective therapeutic strategies.

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

Publication typeCase ReportsJournal Article

Summary

Peer-reviewed research on safety and infection-control considerations relevant to leech therapy and anticoagulation. Indexed in PubMed and verified against the NCBI record.

Why This Matters for Hirudotherapy

These two case reports describe human Wohlfahrtiimonas chitiniclastica infections associated with chronic osteomyelitis and soft-tissue wounds; notably, Case 1 is a 75-year-old man whose chronic post-fracture lower-leg wound worsened 'due to inappropriate treatments like moxibustion and leech therapy,' progressing despite cefoxitin antibiotic therapy to amputation, with diagnosis confirmed by MALDI-TOF MS and 16S rRNA gene sequencing. This is directly relevant to hirudotherapy as a documented safety signal: it illustrates that leech application on poorly selected wounds and under inadequate hygiene can be associated with severe infection, reinforcing ASH's emphasis on patient selection, sterile technique, and antibiotic awareness. Caveat: as an uncontrolled two-patient report the abstract does not establish that leech therapy caused the W. chitiniclastica infection (the cases were polymicrobial and multifactorial), so it should be cited as a cautionary adverse-event observation, not as proof of causation.

Citation

Wohlfahrtiimonas chitiniclastica Infections in two patients with osteomyelitis, China.

Meng et al. · IDCases, 2025

Added to ASH library: May 28, 2026 · Site last updated: June 18, 2026

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