Hemorrhagic shock in a pediatric patient undergoing hirudotherapy: a case report and recommendations for vigilance

Abstract Background Hirudotherapy, the use of leeches for medicinal purposes, is a recognized treatment for various medical conditions, including digit replantation. Case presentation We present a case of a 12-year-old male who developed hemorrhagic shock while undergoing hirudotherapy. Although there is evidence of its benefit, leech therapy can lead to substantial blood loss, especially because it is often combined with additional anticoagulation measures. Conclusions This case emphasizes the need for extreme vigilance and continuous monitoring in pediatric patients undergoing hirudotherapy. We discuss potential risk factors, signs of occult bleeding, and recommend adjunctive measures to improve the assessment of critically ill patients in such situations.