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Lymphangitis Clinical Presentation

  • Author: Raymond D Pitetti, MD, MPH; Chief Editor: Russell W Steele, MD  more...
 
Updated: Aug 13, 2015
 

History

A history of minor trauma to an area of skin distal to the site of infection is often elicited in patients with lymphangitis.[3, 4]

Children with lymphangitis often have fever, chills, and malaise, and some children may report a headache, loss of appetite, and muscle aches.

Patients often have a history of a recent cut or abrasion or of an area of skin that appears infected and spreading.

Lymphangitis can progress rapidly to bacteremia and disseminated infection and sepsis, particularly when caused by group A streptococci.

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Physical Examination

Upon clinical examination, erythematous and irregular linear streaks extend from the primary infection site toward draining regional nodes. These streaks may be tender and warm. Other characteristics can include the following:

  • The primary site may be an abscess, an infected wound, or an area of cellulitis
  • Blistering of the affected skin may occur
  • Lymph nodes associated with the infected lymphatic channels are often swollen and tender
  • Patients may be febrile and tachycardic
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Contributor Information and Disclosures
Author

Raymond D Pitetti, MD, MPH Associate Professor, Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Pittsburgh School of Medicine; Associate Division Chief, Division of Pediatric Emergency Medicine, Associate Medical Director, Emergency Department, Medical Director, Sedation Services, Medical Director, Express Care, Medical Director, Patient Safety, Consulting Staff, Children's Hospital of Pittsburgh of UPMC and University of Pittsburgh Physicians

Raymond D Pitetti, MD, MPH is a member of the following medical societies: American Academy of Pediatrics, Pennsylvania Medical Society, Society for Pediatric Research, Allegheny County Medical Society

Disclosure: Nothing to disclose.

Chief Editor

Russell W Steele, MD Clinical Professor, Tulane University School of Medicine; Staff Physician, Ochsner Clinic Foundation

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, Southern Medical Association

Disclosure: Nothing to disclose.

Acknowledgements

Larry I Lutwick, MD Professor of Medicine, State University of New York Downstate Medical School; Director, Infectious Diseases, Veterans Affairs New York Harbor Health Care System, Brooklyn Campus

Larry I Lutwick, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Gary J Noel, MD Professor, Department of Pediatrics, Weill Cornell Medical College; Attending Pediatrician, New York-Presbyterian Hospital

Gary J Noel, MD is a member of the following medical societies: Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

References
  1. Akogun OB, Akogun MK, Apake E, Kale OO. Rapid community identification, pain and distress associated with lymphoedema and adenolymphangitis due to lymphatic filariasis in resource-limited communities of North-eastern Nigeria. Acta Trop. 2011 Sep. 120 Suppl 1:S62-8. [Medline].

  2. Akogun OB, Badaki JA. Management of adenolymphangitis and lymphoedema due to lymphatic filariasis in resource-limited North-eastern Nigeria. Acta Trop. 2011 Sep. 120 Suppl 1:S69-75. [Medline].

  3. Abraham S, Tschanz C, Krischer J, Saurat JH. Lymphangitis due to insect sting. Dermatology. 2007. 215(3):260-1. [Medline].

  4. Marque M, Girard C, Guillot B, Bessis D. Superficial lymphangitis after arthropod bite: a distinctive but underrecognized entity?. Dermatology. 2008. 217(3):262-7. [Medline].

  5. Tomas X, Pedrosa M, Soriano A, Zboromyrska Y, Tudo G, Garcia S, et al. Rare diagnosis of nodular lymphangitis caused by Mycobacterium marinum: MDCT imaging findings. Acta Radiol Short Rep. 2014 Feb. 3 (2):2047981614523172. [Medline].

  6. Hirschmann JV. Antimicrobial therapy for skin infections. Cutis. 2007 Jun. 79(6 Suppl):26-36. [Medline].

  7. [Guideline] Calfee DP, Salgado CD, Classen D, Arias KM, Podgorny K, Anderson DJ, et al. Strategies to prevent transmission of methicillin-resistant Staphylococcus aureus in acute care hospitals. Infect Control Hosp Epidemiol. 2008 Oct. 29 Suppl 1:S62-80. [Medline].

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