A 37-year-old injecting drug user presented with signs and symptoms of septic arthritis. Staphylococcus aureus was grown from his blood cultures. Despite treatment with flucloxacillin and fusidic acid his condition continued to deteriorate. Echocardiography showed no signs of endocarditis. Culture of his knee aspirate grew Anaerococcus prevotii after 5 days of incubation. Metronidazole was added to his treatment regime. A collection of pus (800 ml) was drained from the right thigh and A prevotii was isolated. His condition improved gradually and he was subsequently transferred to a drug rehabilitation unit after completing his antibiotic course. The importance of anaerobic streptococci in septic arthritis, as a very rare cause, is highlighted.

Jalaukavacharana is the ancient technique used for Raktmokshana, here Jalauka means leeches and avacharana means application. Jalauka is one of the tools for Raktmokshana, among Shring, Alabu and Prachhana where Jalauka, Shring, Alabu are used for Pitta, Vata, Kahpa Doshaj Vyadhi respectively. Jalaukavacharana (leech therapy) is a non-surgical type of Raktamokshana and considered as the most unique and effective method of bloodletting. A lot of research work has been carried out in Ayurveda and Modern medicine to prove efficacy of leech therapy in various disorders. Leeches are widely used in most of the disorders ranging from skin disease to Ischemic heart disease with evidence of successful results. In the present paper effort has been made to review various scientific studies which have been conducted in Ayurveda as well as Modern medicine and study the indications of Jalaukavacharana in various disorders as per Ayurveda and Modern medicine. This paper also studies the possible complications of Jalaukavacharana. Keywords: Jaloukavacharana, Raktmokshana, Leech therapy, Bloodletting, Hirudo therapy.