Leeches as further potential vectors for rickettsial infections

We were very interested in the discovery and comprehensive investigation by Dieme et al. (1) of mosquitos as potential vectors for Rickettisa felis. We would like to draw attention to another ectoparasite that we encountered as a possibly overlooked potential vector for rickettsial infections: the leech. In 2008, a 39-y-old diabetic woman was admitted to a hospital in Northern Laos with a 7-d history of fever, headaches, limb pains, chills, and 2 d of nausea and vomiting. She had a typical eschar on her right anteromedial thigh (7 × 4 mm) (Fig. 1). She remembered being bitten by a terrestrial leech (Haemadipsida spp.), while working in a rice field, exactly …