Aisvarya Kapoor Attending Consultant, Department of Emergency Medicine, Max Hospital, Shalimar Bagh, New Delhi-110088, India
Ritul Srivastava Resident, Department of Emergency Medicine, Max Hospital, Shalimar Bagh, New Delhi-110088, India
Kishalay Datta Associate Director, Department of Emergency Medicine, Max Hospital, Shalimar Bagh, New Delhi-110088, India
Address for correspondence: Aisvarya Kapoor, Attending Consultant, Department of Emergency Medicine, Max Hospital, Shalimar Bagh, New Delhi-110088, India E-mail: dr.sajidn@gmail.com
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Ritul Srivastava, Aisvarya Kapoor, Kishalay Datta/A Rare Case of Leech Therapy Induced Right Foot and Leg Cellulitis with
Septic Shock/Indian J Emerg Med 2022;8(2):53–57.
Timeline
Received : March 07, 2022
Accepted : April 11, 2022
Published : June 28, 2022
Abstract
A 57 year old female came to emergency department with complaint ofpain and swelling over right foot and leg
distally. On local examination there was multiple scar marks with redness and blisters formation. Patient was also
giving complaint of discharge from the site since night yesterday. On further examination the patient was conscious
and little drowsy but in arousable state. On further evaluation, the patient was hypotensive with tachycardia
andtachypnoea. Patient was known case of Arthritis and Hypothyroidism. On further assessment attendants gave history of Leech therapy over right foot and leg distally since 20 days prior coming to emergency department. The leech therapy was
started at an Ayurvedic hospital for detoxification from steroid. Patient was on steroids since long time for arthritis
and she was told in ayurvedic hospital that leech therapy will detoxify her blood and remove excess steroids from
her body. Patient was immediately taken on to symptomatic supportive treatment with intravenous antibiotics,
intravenous fluids and ionotropic support. All relevant investigations sent from emergency department and patient
was admitted in Intensive Care Unit for observation. Patient was discharged after 5 days in haemodynamically
stable condition.
References
1. Judith E. Tintinalli,J. Stephan Stapczynski,O. John Ma,Donald M. Yealy,Garth D. Meckler,David M. Cline. Tintinalli’s Emergency Medicine, 8th ed. united states: McGraw-Hill Education;2016.
2. Utevsky, S.; Zagmajster, M.; Trontelj, P. (2014). “Hirudomedicinalis”. IUCN Red List of Threatened Species. 2014: e.T10190A21415816. d o i : 1 0 . 2 3 0 5 / I U C N . U K . 2 0 1 4 - 1 . R L T S . T10190A21415816.en. Retrieved 19 November 2021.
3. Buczyński, Paweł; Tończyk, Grzegorz; Bielecki, Aleksander; Cichocka, Joanna M.; Kitowski, Ignacy; Grzywaczewski, Grzegorz; Krawczyk, Rafał; Nieoczym, Marek; Jabłońska, Aleksandra; Pakulnicka, Joanna; Buczyńska, Edyta (April 2014). “Occurrence of the medicinal leech (Hirudomedicinalis) in birds’ nests”. Biologia. 69 (4): 484–488. doi:10.2478/
4. “Biology”. SanguesMedicinales. Ricarimpex. Archived from the original on October 10, 2018.Retrieved November 26, 2012.
5. Brockbank, William (1952). Portrait of a Hospital. London: William Heinemann. p. 73.
6. Altman, Lawrence K. (February 17, 1981). “The doctor’s world; leeches still have their medical uses”. The New York Times. p. 2.
7. “Applications in General Medicine”. SanguesMedicinales. Ricarimpex. Archived from the original on March 6, 2013. Retrieved November 26, 2012.
8. Salleh, Anna. A mechanical medicinal leech? ABC Science Online. December 14, 2001. Retrieved on July 29, 2007.
9. Fox, Maggie. “ENT Research Group Recognized for Mechanical Leech Project”. Otoweb News. University of Wisconsin, Madison, Division of Otolaryngology. Archived from the original on December 11, 2006. Retrieved December 16, 2013.
10. “Product Classification: Leeches, Medicinal”. www.accessdata.fda.gov. Retrieved 19 August 2019.
11. Sket, Boris; Trontelj, Peter (2008). “Global diversity of leeches (Hirudinea) in freshwater”. Hydrobiologia. 595 (1): 129–137. doi:10.1007/s10750-007-9010-8. S2CID 46339662.
12. Fogden, S.; Proctor, J. (1985). “Notes on the Feeding of Land Leeches (Haemadipsazeylanica Moore and H. picta Moore) in GunungMulu National Park, Sarawak”. Biotropica. 17 (2): 172–174. doi:10.2307/2388511. JSTOR 2388511.
13. Siddall, Mark E. (1998). “Glossiphoniidae”. American Museum of Natural History. Retrieved 1 May 2018.
14. Meyer, Marvin C. (July 1940). “A Revision of the Leeches (Piscicolidae) Living on FreshWater Fishes of North America”. Transactions of the American Microscopical Society. 59 (3): 354–376. doi:10.2307/3222552. JSTOR 3222552.
15. “Leeches”. Australian Museum. 14 November 2019. Retrieved 3 June 2020.
16. Meir, Rigbi; Levy, Haim; Eldor, Amiram; Iraqi, Fuad; Teitelbaum, Mira; Orevi, Miriam; Horovitz, Amnon; Galun, Rachel (1987). “The saliva of the medicinal leech Hirudomedicinalis—II. Inhibition of platelet aggregation and of leukocyte activity and examination of reputed anaesthetic effects”. Comparative Biochemistry and Physiology C. 88 (1): 95–98. doi:10.1016/0742-8413(87)90052-1. PMID 2890494.
17. Siddall, Mark; Borda, Liz; Burreson, Gene; Williams, Juli. “Blood Lust II”. Laboratory of Phylohirudinology, American Museum of Natural History. Retrieved 15 December 2013.
18. “Proverbs 30:15 | Ellicott’s Commentary for English Readers”. BibleHub. Retrieved 27 April 2018.
19. Payton, Brian (1981). Muller, Kenneth; Nicholls, John; Stent, Gunther (eds.). Neurobiology of the Leech. Cold Spring Harbor Laboratory. pp. 27–34. ISBN 978-0-87969-146-2.
20. Lamarck, Jean-Baptiste (1818). Histoire naturelle des animaux sans vertèbres ... précédéed’une introduction offrant la détermination des caractèresessentiels de l’animal, sa distinction du végétal et des autres corps naturels, enfin, l’exposition des principesfondamentaux de la zoologie. Volume 5. Vol. 5. Paris: Verdière.
21. Phillips, Anna J.; Dornburg, Alex; Zapfe, Katerina L.; Anderson, Frank E.; James, Samuel W.; Erséus, Christer; Moriarty Lemmon, Emily; Lemmon, Alan R.; Williams, Bronwyn W. (2019). “Phylogenomic Analysis of a Putative Missing Link Sparks Reinterpretation of Leech Evolution”. Genome Biology and Evolution. 11 (11): 3082–3093. doi:10.1093/gbe/evz120. ISSN 1759-6653. PMC 6598468. PMID 31214691.
22. Thorp, James H.; Covich, Alan P. (2001). Ecology and Classification of North American Freshwater Invertebrates. Academic Press. p. 466. ISBN 978-0-12-690647-9.
23. Buchsbaum, Ralph; Buchsbaum, Mildred; Pearse, John; Pearse, Vicki (1987). Animals Without Backbones (3rd ed.). The University of Chicago Press. pp. 312–317. ISBN 978-0-226- 07874-8.
24. Mory, Robert N.; Mindell, David; Bloom, David A. (2014). “The Leech and the Physician: Biology, Etymology, and Medical Practice with Hirudineamedicinalis”. World Journal of Surgery. 24 (7): 878–883. doi:10.1007/s002680010141. hdl:2027.42/42411. ISSN 0364-2313. PMID 10833259. S2CID 18166996.
25. anon (2016). Medicine: The Definitive Illustrated History. Dorling Kindersley. p. 35. ISBN 978-0-241-28715-6.
26. Adams, Stephen L. (1988). “The Medicinal Leech: A Page from the Annelids of Internal Medicine”. Annals of Internal Medicine. 109 (5): 399–405. doi:10.7326/0003-4819 109-5-399. PMID 3044211.
27. Michalsen, A.; Moebus, S.; Spahn, G.; Esch, T.; Langhorst, J.; Dobos, G.J. (2002). “Leech therapy for symptomatic treatment of knee osteoarthritis: Results and implications of a pilot study”. Alternative Therapies in Health and Medicine. 8 (5): 84–88. PMID 12233807.
28. Sawyer, R. T. (1970). “Observations on the Natural History and Behavior of Erpobdellapunctata (Leidy) (Annelida: Hirudinea)”. The American Midland Naturalist. 83 (1): 65–80. doi:10.2307/2424006. JSTOR 2424006.
29. Sig, A. K.; Guney, M.; UskudarGuclu, A.; Ozmen, E. (2017). “Medicinal leech therapy— an overall perspective”. Integrative Medicine Research. 6 (4): 337–343. doi:10.1016/j.imr.2017.08.001. PMC 5741396. PMID 29296560.
30. Gelder, Stuart R.; Gagnon, Nicole L.; Nelson, Kerri (2002). “Taxonomic Considerations and Distribution of the Branchiobdellida (Annelida: Clitellata) on the North American Continent”. Northeastern Naturalist. 9 (4): 451–468. doi:10.1656/1092-6194(2002)009[0451:TCADOT]2.0.CO;2. JSTOR 3858556.
31. Haycraft, John B. (1883). “IV. On the action of a secretion obtained from the medicinal leech on the coagulation of the blood”. Proceedings of the Royal Society of London. 36 (228–231): 478–487. doi:10.1098/rspl.1883.0135.
32. Dziekońska-Rynko, Janina; Bielecki, Aleksander; Palińska, Katarzyna (2009). “Activity of selected hydrolytic enzymes from leeches (Clitellata: Hirudinida) with different feeding strategies”. Biologia. 64 (2): 370–376. doi:10.2478/s11756-009-0048-0.
33. Fischer, Karl-Georg; Van de Loo, Andreas; Bohler, Joachim (1999). “Recombinant hirudin (lepirudin) as anticoagulant in intensive care patients treated with continuous hemodialysis”. Kidney International. 56 (Suppl. 72): S46–S50. doi:10.1046/j.1523-1755.56.s72.2.x. PMID 10560805.
34. Smith, Douglas Grant (2001). Pennak’s Freshwater Invertebrates of the United States: Porifera to Crustacea. John Wiley & Sons. p. 305. ISBN 978-0-471-35837-4.
35. Schnell, Ida Bærholm; Thomsen, Philip Francis; Wilkinson, Nicholas; Rasmussen, Morten; Jensen, Lars R. D.; Willerslev, Eske; Bertelsen, Mads F.; Gilbert, M. Thomas P. 2012). “Screening mammal biodiversity using DNA from leeches”. Current Biology. 22 (8): R262– R263. doi:10.1016/j.cub.2012.02.058. ISSN 0960-9822. PMID 22537625
Data Sharing Statement
There are no additional data available. All raw data and code are available upon request.
Funding
This research received no funding.
Author Contributions
All authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
Acknowledgements
We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.
Conflicts of Interest
No conflicts of interest in this work.
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Cite this article
Ritul Srivastava, Aisvarya Kapoor, Kishalay Datta/A Rare Case of Leech Therapy Induced Right Foot and Leg Cellulitis with
Septic Shock/Indian J Emerg Med 2022;8(2):53–57.
This license
enables reusers to distribute, remix, adapt, and build upon the material in any
medium or format for noncommercial purposes only, and only so long as
attribution is given to the creator.
This license
enables reusers to distribute, remix, adapt, and build upon the material in any
medium or format for noncommercial purposes only, and only so long as
attribution is given to the creator.