Keratitis following leech therapy for periocular eczematous dermatitis: a case report

Abstract

Background The medicinal leech therapy (MLT) is a kind of complementary treatment method used for various diseases. The leeches (Hirudo medicinalis) have been used for more than 2500 years by surgeons. The substances presenting in the saliva of leeches have anti-inflammatory, anticoagulant, platelet inhibitory, thrombin regulatory, analgesic, extracellular matrix degradative and antimicrobial effects. The method is cheap, easy to apply, effective and its mechanisms of action have been clarified for specific diseases. Infection particularly Aeromonas infection is the most common complication of MLT. Case presentation In this case report, a keratitis case developing after leech therapy applied for the periocular and facial eczematous dermatitis lesions will be presented. The patient referred to our hospital with decreased vision, ocular pain, stinging, redness and lacrimation complaints. A large corneal epithelial defect with irregular margins, dying by fluorescein, involving more than inferior half of cornea and conjunctival hyperemia were seen in the right eye. No agent was determined in microbiological investigation, as the patient had used topical moxifloxacin eye drop which was commenced in another clinic before applying to us. The patient was treated with fortified vancomycin and ceftazidime, before using besifloxacin with the diagnosis of bacterial keratitis. Three weeks later epithelial defect improved completely leaving an opacity and neovascularization. Conclusions MLT should be performed by certified physicians with sterile medicinal leeches and precautious antibiotics should be used before MLT for prevention against potential infections.

Animal healer for refractory diseases: Myth or reality?

“…Despite its benefits, the main complication of leech therapy is infection, including cellulitis, perianal abscess, and keratitis, with infection rates reported between 2 % and 36 % [ [65] , [66] , [67] , [68] ]. Additionally, the bites of leech can cause mild skin itching, which can last for hours to three days [ 63 ].…”

“…Additionally, the bites of leech can cause mild skin itching, which can last for hours to three days [ 63 ]. Due to the saliva of leeches contains anticoagulant and vasodilator components, secondary bleeding and anaemia after leech treatment also occurs sometimes [ 67 , 68 ]. Even so, the potential of this animal healer in medical field has attracted wide attention, including pain syndrome, inflammatory conditions, reconstructive surgeries, dentistry, and ophthalmological and ear nose throat disorders.…”