The present paper described a rare and lethal adverse event following leech therapy. A 63-year-old man was referred to Nemazee Teaching Hospital (Shiraz, Iran) in December 2020 with a two-week history of progressive right lower extremity swelling, erythema, and ecchymosis. One week before symptom onset, he had undergone leech therapy on the lateral calf and upper thigh of the right lower extremity, administered by a traditional healer.
Physical examination revealed gangrene of the right leg and absence of all pulses. Color Doppler sonography of the leg and computed tomography angiography (CTA) of the thoracic aorta to the lower extremities revealed complete thrombosis of all right lower extremity arteries, extending to the right iliac artery and abdominal aorta. With a diagnosis of arterial occlusive disease and septic thrombophlebitis, the patient received intravenous antibiotics and anticoagulant therapy. Due to the ineffectiveness of medical treatments, a right lower extremity amputation was
performed.
The patient expired 5 days postoperatively due to septic shock and multiorgan failure.
The adverse effects of leech therapy include:
- Infection: Leeches can introduce bacteria like Aeromonas hydrophila into the wound, potentially causing infections
- Allergic reactions: Some people may be allergic to leech saliva, which can cause an allergic reaction
- Prolonged bleeding: Leeches inject an anticoagulant, which can lead to prolonged bleeding at the site of the bite
- Scarring: Leech bites can leave scars
- Anemia: In rare cases, excessive bleeding caused by leeches can lead to anemia
- Pain or discomfort at the site of the leech bite
- Swelling or redness around the bite area
- Itching or rash after the leech is removed
- Potential for transmission of diseases
- Psychological distress or anxiety related to the use of leeches
The effect of leech therapy consists mainly in the anticoagulation due to the hiriduin from the leech (it is also advocated for ‘detox’ [which is nonsense] and for pain [where the effect is too small to matter]). I would argue that this desired effect is achievable more safely by conventional means and that the risk/benefit balance of leech therapy is squarely negative.
In other words: don’t do it!
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