Theraputic use of leeches and infection: a case series

The therapeutic use of leeches can be traced as far back as 2,500 years when they were used for bloodletting in ancient India. The modern use of leeches in medicine, or Hirudotherapy, made its comeback in the 1980’s with the advent of microsurgeries, such as plastic and reconstructive surgery.

A common complication of these kinds of surgeries is congestion caused by coagulated blood. If this congestion is not cleared up quickly, arteries that bring the tissues necessary nourishment will become plugged, and the tissues will die. To combat this, leeches are applied to the congested area and begin to consume excess blood, this process along with a natural anticoagulant found in the leeches’ saliva, combine to allow fresh oxygenated blood into the area.

In a paper published in Journal Medical Case Reports Ben Maetz et al present a case series documenting two reports of septicaemia contracted from the application of leeches following breast reconstruction surgery.

The authors found similar cases of infection reported in the literature, with infections attributed to bacteria found in the leeches’ digestive tracts. Infection rates varied between 2.4% and 20% with the concentration of bacteria inside leeches’ digestive tracts largely decreasing when the patient was placed under antibiotherapy. The authors go on to recommend preventative treatment with oral antibiotics for the duration of treatment by leeches.

The use of leeches in modern medicine is an important tool for physicians. This case series highlights that, while not the norm, the rate of infections following Hirudotherapy is not negligible and should be considered when assigning treatment.

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