Management of Leech Bites

Initial Management

• Thoroughly irrigate the leech bite wound with copious amounts of warm or room temperature potable water to remove any foreign matter and reduce the risk of infection, as recommended by the American Heart Association 1, 2
• Do not apply suction to the wound, as this is not recommended for bite wounds and may cause further tissue damage, according to the American Heart Association 1

Wound Care

• After bleeding is controlled, cover the wound with an antibiotic ointment or cream and a clean occlusive dressing to improve healing and reduce infection risk, as suggested by the American Heart Association 1, 2
• Monitor the wound for signs of infection, including increasing pain, redness, swelling, or purulent discharge, as advised by the World Journal of Emergency Surgery 3

When to Consider Antibiotics

• Universal prophylaxis with antibiotics is not generally recommended for bite wounds, according to the World Journal of Emergency Surgery 3, 4
• Consider antibiotics for deep wounds or wounds in critical areas, patients with compromised immune status or severe comorbidities, and signs of infection or systemic symptoms, as recommended by the World Journal of Emergency Surgery 3, 4, 5

Special Considerations

• Ensure tetanus prophylaxis is current, as with any break in the skin integrity, as advised by the Infectious Diseases Society of America 6, 7
• Do not close infected wounds, as this may lead to abscess formation, according to the Infectious Diseases Society of America 6, 7

When to Seek Medical Attention

• If signs of infection develop, such as increasing pain, redness, warmth, swelling, or purulent discharge, seek medical attention, as advised by the World Journal of Emergency Surgery 3
• If systemic symptoms occur, such as fever, chills, or lymphadenopathy, seek medical attention, as recommended by the World Journal of Emergency Surgery 3