Leech bites: massive bleeding, coagulation profile disorders, and severe anemia

Leeches have been in use for centuries, especially in plastic and reconstructive surgery wound and flap healing, in venous insufficiencies, and in the treatment of many disorders such as hemorrhoids and varicosity. With this study, we aimed to discuss coagulation disorder due to uncontrolled leech bites, consequent excessive skin hemorrhage, and anemia requiring blood transfusion. A 65-year-old male patient was referred to the emergency department because of excessive intractable bleeding that had occurred after leech bites. On physical examination, a total of 130 bites were detected on various regions of the body. In the laboratory findings of the patient, hemoglobin and hematocrit levels were extremely low, and prothrombin time, international normalized ratio, and partial thromboplastin time were markedly increased. The patient received a total of 8 units of fresh frozen plasma and 6 units of erythrocyte suspension. Bleeding stopped by decreasing after the transfusion of fresh frozen plasma. Although the complications due to leech injuries are rare, they may be an important cause of morbidity and mortality when an injury or prolonged bleeding in an internal region occurs. Prolonged skin hemorrhages rarely cause anemia, and deaths are caused by intractable hemorrhages. However, a coagulation disorder and consequent intractable hemorrhage have not been reported previously in the literature. In conclusion, it should be known that uncontrolled, blind, and excessive leech use causes severe hemorrhage and excessive blood loss, causing significant morbidity and mortality. Therefore, the awareness of either physicians or people using or recommending alternative medicine should be raised on this subject.

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

Case of 65-year-old male with 130 leech bites causing severe coagulation disorder and anemia requiring 8 units of fresh-frozen plasma and 6 units of erythrocyte suspension.

Explore cómo esta investigación se conecta con la práctica clínica

More peer-reviewed studies in Seguridad y control de infecciones.

• Leech-Assisted Flap Salvage — Systematic Review of 277 Cases — Whitaker et al. (2012)
• Effects of hirudotherapy on liver functions, lipid profile, and insulin sensitivity in rats with metabolic syndrome — Bilden A et al. (2026)
• AIF-1 and RNASET2 Play Complementary Roles in the Innate Immune Response of Medicinal Leech — Baranzini N et al. (2019)
• [Hirudo medicinalis-leech applications in plastic and reconstructive microsurgery--a literature review] — Knobloch K et al. (2007)
• Bacterial symbioses of the medicinal leech Hirudo verbana — Nelson M, Graf J (2012)
• Leech related Aeromonas complex infection after reconstruction with a microvascular forearm flap — Beger B, von Loewenich F, Goetze E, Moergel M, Walter C (2016)
• Aeromonas septicemia after medicinal leech use following replantation of severed digits — Levine SM, Frangos SG, Hanna B, Colen K, Levine JP (2009)
• Outcomes of flap salvage with medicinal leech therapy — Nguyen MQ et al. (2012)
• The role of leech water sampling in choice of prophylactic antibiotics in medical leech therapy — Wilmer A et al. (2013)
• The development and application of mini-barcodes from mitochondrial DNA for identifying medicinal leeches from traditional medicines — Liu Y et al. (2025)

Browse all ASH-analysed research →