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Lethal Aeromonas veronii Sepsis in the Course of Medicinal Leech Therapy

A patient with oral squamous cell carcinoma (OSCC) underwent complex surgical tumor therapy, including the reconstruction of soft tissues using a radial forearm flap. Due to venous congestion that could only partly be resolved by revision surgery, leech therapy was started on the second postoperativ...

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Autores principales: Sproll, Christoph, Lommen, Julian, Balasiu, Adriana, Schorn, Lara, Kübler, Norbert R., Henrich, Birgit, Kram, Rainer, Petersdorf, Sabine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9495195/
https://www.ncbi.nlm.nih.gov/pubmed/36139958
http://dx.doi.org/10.3390/antibiotics11091180
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author Sproll, Christoph
Lommen, Julian
Balasiu, Adriana
Schorn, Lara
Kübler, Norbert R.
Henrich, Birgit
Kram, Rainer
Petersdorf, Sabine
author_facet Sproll, Christoph
Lommen, Julian
Balasiu, Adriana
Schorn, Lara
Kübler, Norbert R.
Henrich, Birgit
Kram, Rainer
Petersdorf, Sabine
author_sort Sproll, Christoph
collection PubMed
description A patient with oral squamous cell carcinoma (OSCC) underwent complex surgical tumor therapy, including the reconstruction of soft tissues using a radial forearm flap. Due to venous congestion that could only partly be resolved by revision surgery, leech therapy was started on the second postoperative day. The patient developed pneumonia and sepsis and died as a result of septic shock, despite having received targeted broad-spectrum antibiotic therapy since day 5. Aeromonas spp. were cultured from both the patient’s specimens and unused leeches. Biochemical identification and matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) yielded inconsistent identification results. Finally, microbiological identification of Aeromonas spp. was performed via 16S rDNA sequencing and use of the basic local alignment search tool (BLAST), and strains from both the patient and the leeches were identified as Aeromonas veronii. Aeromonas spp. strains derived from the patient and leeches and independent laboratory strains were submitted to randomly amplified polymorphic DNA (RAPD) subtyping. RAPD of A. veronii strains from both sources revealed an identical pattern, strongly suggesting the transmission of A. veronii from the leeches to the patient. Physicians should be aware of the potential for severe lethal infections as a fatal side-effect of leech therapy in critically ill patients, which should be addressed using antibiotic prophylaxis.
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spelling pubmed-94951952022-09-23 Lethal Aeromonas veronii Sepsis in the Course of Medicinal Leech Therapy Sproll, Christoph Lommen, Julian Balasiu, Adriana Schorn, Lara Kübler, Norbert R. Henrich, Birgit Kram, Rainer Petersdorf, Sabine Antibiotics (Basel) Case Report A patient with oral squamous cell carcinoma (OSCC) underwent complex surgical tumor therapy, including the reconstruction of soft tissues using a radial forearm flap. Due to venous congestion that could only partly be resolved by revision surgery, leech therapy was started on the second postoperative day. The patient developed pneumonia and sepsis and died as a result of septic shock, despite having received targeted broad-spectrum antibiotic therapy since day 5. Aeromonas spp. were cultured from both the patient’s specimens and unused leeches. Biochemical identification and matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) yielded inconsistent identification results. Finally, microbiological identification of Aeromonas spp. was performed via 16S rDNA sequencing and use of the basic local alignment search tool (BLAST), and strains from both the patient and the leeches were identified as Aeromonas veronii. Aeromonas spp. strains derived from the patient and leeches and independent laboratory strains were submitted to randomly amplified polymorphic DNA (RAPD) subtyping. RAPD of A. veronii strains from both sources revealed an identical pattern, strongly suggesting the transmission of A. veronii from the leeches to the patient. Physicians should be aware of the potential for severe lethal infections as a fatal side-effect of leech therapy in critically ill patients, which should be addressed using antibiotic prophylaxis. MDPI 2022-08-31 /pmc/articles/PMC9495195/ /pubmed/36139958 http://dx.doi.org/10.3390/antibiotics11091180 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Sproll, Christoph
Lommen, Julian
Balasiu, Adriana
Schorn, Lara
Kübler, Norbert R.
Henrich, Birgit
Kram, Rainer
Petersdorf, Sabine
Lethal Aeromonas veronii Sepsis in the Course of Medicinal Leech Therapy
title Lethal Aeromonas veronii Sepsis in the Course of Medicinal Leech Therapy
title_full Lethal Aeromonas veronii Sepsis in the Course of Medicinal Leech Therapy
title_fullStr Lethal Aeromonas veronii Sepsis in the Course of Medicinal Leech Therapy
title_full_unstemmed Lethal Aeromonas veronii Sepsis in the Course of Medicinal Leech Therapy
title_short Lethal Aeromonas veronii Sepsis in the Course of Medicinal Leech Therapy
title_sort lethal aeromonas veronii sepsis in the course of medicinal leech therapy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9495195/
https://www.ncbi.nlm.nih.gov/pubmed/36139958
http://dx.doi.org/10.3390/antibiotics11091180
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