ABSTRACT
Medicinal leeches are well-established for promoting venous drainage in transplants/flaps and analgesia in osteoarthritis. Although medicinal leeches are bred and kept under controlled conditions, they are colonised by a genuine species-specific bacterial flora. Therapeutic application of leeches implies skin penetration carrying an a priori risk of infection. We report 2 cases with different indications for medicinal leech therapy. In both cases wound infection occurred in close temporal and spatial correlation or with evidence of a leech-associated germ that could be treated successfully. An unclarified complication rate warrants strict indications for the application of medicinal leeches. Preventive measures are currently tested.
Subject(s)
Aeromonas , Ankle Joint , Anti-Bacterial Agents/therapeutic use , Compartment Syndromes/therapy , Contusions/therapy , Erysipelas/therapy , Gram-Negative Bacterial Infections/therapy , Hirudo medicinalis/microbiology , Leeching/adverse effects , Leg Injuries/therapy , Occupational Injuries/therapy , Osteoarthritis, Knee/therapy , Osteoarthritis/therapy , Surgical Flaps , Surgical Wound Infection/therapy , Adult , Aged , Animals , Combined Modality Therapy , Erysipelas/transmission , Female , Gram-Negative Bacterial Infections/transmission , Humans , Male , Surgical Wound Infection/transmissionABSTRACT
The epidermis, the human being's primary protection against infection and aggression, can crack or split, and result in microbial bacteria penetrating it. Infections may, however, stem from other sources, such as viruses which enter the body via the respiratory tract, and then appear on the skin.
Subject(s)
Skin Diseases, Infectious/pathology , Erysipelas/immunology , Erysipelas/pathology , Erysipelas/transmission , Genital Diseases, Male/pathology , Humans , MaleABSTRACT
OBJECTIVE: Erysipela is a common skin infection readily found in patients with venous insufficiency or lymphedema. The aim of this work was to measure the incidence of erysipela in a spa resort specialized in the treatment of venous and lymphatic diseases and to evaluate the influence of a preventive strategy principally based on education of patients at risk. PATIENTS AND METHODS: The measurement of incidence was based on the detection of the reasons for which the patients did not attend their thermal care sessions. Quality control was obtained from the reports of cases diagnosed by local private and public health care centers. RESULTS: The incidence of erysipela in this high risk population was 40.2 and 48.5 cases for 1000 persons per exposure-year in 1993 and 1994 respectively. The preventive strategy carried out was able to induce a reduction of 65% during the next years (p<0.01). CONCLUSION: This study confirms the high incidence of erysipela in subjects with severe venous insufficiency or lymphedema and the efficacy of an active educational preventive strategy.
