Leech-borne Serratia marcescens infection following complex hand injury

Leeches are commonly used in the postoperative course of plastic surgical o perations where there is venous congestion in a pedicled or free flap. They provide a temporary relief to venous engorgement whilst venous drainage is re-established. It is known that leeches can carry Aeromonas hydrophila in fection, and a second or third generation cephalosporin antibiotic has trad itionally been given as prophylaxis against infection. We report a new obse rvation that leeches can carry Serratia marcescens and give rise to clinica lly significant infection. The implication for prophylaxis and treatment of leech-associated cellulitis is discussed.