eMedicine Specialties > Pediatrics: General Medicine > Infectious Disease

Lymphangitis: Follow-up

Author: Raymond D Pitetti, MD, MPH, Associate Professor, Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Pittsburgh School of Medicine; Consulting Staff, University of Pittsburgh Physicians
Contributor Information and Disclosures

Updated: May 22, 2009

Follow-up

Further Inpatient Care

  • Some patients with lymphangitis may require admission for intravenous (IV) antimicrobial therapy.
  • Most authors recommend that children younger than 3 years or children who are febrile and who appear toxic initially be treated with IV antibiotics.
  • Children who have not improved clinically after 48 hours of appropriate PO antimicrobial therapy should receive IV antistaphylococcal and antistreptococcal therapy.
  • When erythema, warmth, and edema are markedly reduced, antibiotics can be changed to the oral (PO) route.

Complications

  • Lymphangitis may spread within hours.
  • Bacteremia and sepsis can occur.
  • Without appropriate antimicrobial therapy, cellulitis may develop or extend along the channels; necrosis and ulceration may occur.
  • Lymphangitis caused by group A beta-hemolytic streptococcus (GABHS) can progress rapidly, leading to bacteremia, sepsis, and death.
  • Guidelines to prevent transmission of methicillin-resistant S aureus have been established.4

Prognosis

  • The prognosis for patients with uncomplicated lymphangitis is good.
  • Antimicrobial regimens are effective in more than 90% of cases.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Failure to provide timely and appropriate antimicrobial therapy may lead to cellulitis, abscess formation, bacteremia, and sepsis.
 


More on Lymphangitis

Overview: Lymphangitis
Differential Diagnoses & Workup: Lymphangitis
Treatment & Medication: Lymphangitis
Follow-up: Lymphangitis
Multimedia: Lymphangitis
References
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References

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Further Reading

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Keywords

lymphangitis, lymphangeitis, lymphangiitis, lymphatic system, inflammation of the lymphatic channels, bacteremia, cellulitis, septic thrombophlebitis, superficial thrombophlebitis, necrotizing fasciitis, myositis, sporotrichosis, Staphylococcus aureus, Pseudomonas, Streptococcus pneumoniae, Pasteurella multocida, Aermonas hydrophila, treatment, diagnosis

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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; Consulting Staff, University of Pittsburgh Physicians
Raymond D Pitetti, MD, MPH is a member of the following medical societies: Allegheny County Medical Society, American Academy of Pediatrics, Pennsylvania Medical Society, and Society for Pediatric Research
Disclosure: Nothing to disclose.

Medical Editor

Gary J Noel, MD, Department of Pediatrics, Clinical Associate Professor, Weill Medical College of Cornell University
Gary J Noel, MD is a member of the following medical societies: Pediatric Infectious Diseases Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

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.

CME Editor

Robert W Tolan Jr, MD, Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine
Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility
Disclosure: GlaxoSmithKline Honoraria Speaking and teaching; MedImmune Honoraria Speaking and teaching; Merck Honoraria Speaking and teaching; sanofi pasteur Honoraria Speaking and teaching; Baxter Healthcare Honoraria Speaking and teaching

Chief Editor

Russell W Steele, MD, Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine
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, and Southern Medical Association
Disclosure: None None None

 
 
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