Medicinal leeches may harbor Aeromonas species in their foregut to aid in the digestion of a blood meal. Using a leech in plastic surgery can result in Aeromonas cellulitis, which may be complicated by sepsis.
Patient risk factors associated with serious infection:
(1) immunosuppression
(2) cirrhosis
(3) underlying malignancy
(4) diabetes mellitus
(5) presence of devascularized, necrotic tissue
Risk factors associated with the leeches:
(1) use of open range leeches (vs those provided by breeders)
(2) keeping leeches in aquariums that are not cleaned or properly maintained
Prophylactic therapy with an antibiotic regimen to which the Aeromonas species is susceptible can significantly reduce the risk of infection and improve graft outcome.
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