Lethal Aeromonas Sepsis in the Course of Medicinal Leech Therapy
Case report published in Antibiotics (Basel) (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
OSCC patient with radial forearm flap developed Aeromonas pneumonia, sepsis and septic shock after leech therapy despite broad-spectrum antibiotics; RAPD confirmed transmission from leeches.
Por qué esto importa para la hirudoterapia
Este reporte de caso documenta un desenlace fatal en un paciente con carcinoma oral de células escamosas reconstruido con un colgajo antebraquial radial que desarrolló sepsis por Aeromonas veronii tras iniciarse terapia con sanguijuelas medicinales por congestión venosa. A pesar de administrar antibióticos de amplio espectro dirigidos desde el día cinco, el paciente falleció por choque séptico; la secuenciación del ARNr 16S y la subtipificación por RAPD confirmaron cepas idénticas de A. veronii tanto en el paciente como en sanguijuelas no utilizadas, lo que indica fuertemente la transmisión de la sanguijuela al paciente. Esto es directamente relevante para el dominio de ASH, ya que destaca una complicación infecciosa letal de la hirudoterapia y subraya la importancia crítica de la profilaxis antibiótica. La salvedad es que se trata de un reporte de caso único en un paciente oncológico en estado crítico, lo que limita la generalizabilidad, y la identificación bioquímica/MALDI-TOF fue inconsistente.
Citación
Lethal Aeromonas Sepsis in the Course of Medicinal Leech Therapy.
Sproll C et al. · Antibiotics, 2022
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026