Lethal Sepsis in the Course of Medicinal Leech Therapy
Case report published in Antibiotics (2022)
Abstract
A patient with oral squamous cell carcinoma (OSCC) underwent complex surgical tumor therapy, including the reconstruction of soft tissues using a radial forearm flap. Due to venous congestion that could only partly be resolved by revision surgery, leech therapy was started on the second postoperative day. The patient developed pneumonia and sepsis and died as a result of septic shock, despite having received targeted broad-spectrum antibiotic therapy since day 5. Aeromonas spp. were cultured from both the patient's specimens and unused leeches. Biochemical identification and matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) yielded inconsistent identification results. Finally, microbiological identification of Aeromonas spp. was performed via 16S rDNA sequencing and use of the basic local alignment search tool (BLAST), and strains from both the patient and the leeches were identified as Aeromonas veronii. Aeromonas spp. strains derived from the patient and leeches and independent laboratory strains were submitted to randomly amplified polymorphic DNA (RAPD) subtyping. RAPD of A. veronii strains from both sources revealed an identical pattern, strongly suggesting the transmission of A. veronii from the leeches to the patient. Physicians should be aware of the potential for severe lethal infections as a fatal side-effect of leech therapy in critically ill patients, which should be addressed using antibiotic prophylaxis.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Patient with oral squamous cell carcinoma receiving leech therapy after radial forearm flap died of Aeromonas septic shock; RAPD subtyping confirmed identical strains from patient and leeches, definitively proving leech-to-patient transmission.
Por qué esto importa para la hirudoterapia
This case report describes a patient with oral squamous cell carcinoma who developed fatal septic shock after leech therapy for venous congestion of a radial forearm flap. Aeromonas veronii was cultured from both the patient and unused leeches, and RAPD subtyping revealed identical patterns, strongly suggesting leech-to-patient transmission. The patient had received broad-spectrum antibiotics from day five but succumbed to pneumonia and sepsis. This case is directly relevant to hirudotherapy safety, demonstrating that Aeromonas transmission from medicinal leeches can cause lethal infection in critically ill patients and underscoring the importance of antibiotic prophylaxis. However, this represents a single fatal case in a medically complex oncology patient, and MALDI-TOF MS yielded inconsistent species identification, requiring 16S rDNA sequencing for definitive identification.
Citación
Lethal Sepsis in the Course of Medicinal Leech Therapy.
Sproll C, Lommen J, Balasiu A et al. · Antibiotics, 2022
Contexto clínico relacionado
Explore cómo esta investigación se conecta con la práctica clínica
Añadido a la biblioteca ASH: May 26, 2026 · Última actualización del sitio: June 18, 2026