Ciprofloxacin-resistant Aeromonas infection following leech therapy for digit replantation: report of 2 cases.

van Alphen, Nickolas A; Gonzalez, Alexandra; McKenna, Maureen C; McKenna, Theresa K; Carlsen, Brian T; Moran, Steven L · J Hand Surg Am · 2014

case_report · Level V

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Abstract

Medicinal leeches are commonly used after finger replantation to treat surgically unsalvageable venous congestion. Infection from Aeromonas hydrophila is a recognized complication of leech therapy that can be underestimated by the medical community. Ciprofloxacin and trimethoprim-sulfamethoxazole are the most commonly recommended prophylactic antibiotics used to prevent A. hydrophila infections during leech therapy. Here, we report 2 cases of ciprofloxacin-resistant Aeromonas infections, occurring within 4 months of each other. Both cases developed after leech therapy for unsuccessful digital replantation. These infections were successfully treated with ceftriaxone. Ciprofloxacin-resistant Aeromonas should be recognized when determining prophylactic antibiotic protocols for replant centers when leech therapy is used for finger replantation.

Medical subject headings