Lymphangitis is inflammation of lymphatic channels due to infectious or noninfectious causes. Potential pathogens include bacteria, mycobacteria, viruses, fungi, and parasites. Lymphangitis most commonly develops after cutaneous inoculation of microorganisms into the lymphatic vessels through a skin wound or a distal infection complication.
2. INTRODUCTION
Lymphangitis is inflammation of lymphatic channels due to infectious or noninfectious
causes. Potential pathogens include bacteria, mycobacteria, viruses, fungi, and parasites.
Lymphangitis most commonly develops after cutaneous inoculation of microorganisms
into the lymphatic vessels through a skin wound or as a complication of a distal infection.
The pathophysiology, clinical manifestations, microbiology, diagnosis, and treatment of
lymphangitis will be reviewed here. Further information about the individual etiologies of
lymphangitis is discussed in detail separately.
3. Lymphangitis is an infection of the lymph vessels (channels).
It is a complication of some bacterial infections.
5. CAUSES
Lymphangitis is a type of secondary infection, which means it happens because of another infection.
When the infection travels from the original site to the lymph vessels, the vessels become inflamed and
infected.
Bacterial infections are the most common cause of lymphangitis. Lymphangitis due to a viral or fungal
infection is also possible. cytomegalovirus, tuberculosis, syphilis, and the fungus Sporothrix schenckii.
Any injury that allows a virus, bacteria, or fungus to enter the body can cause an infection that leads to
lymphangitis. Some possible culprits include:
•puncture wounds, such as from stepping on a nail or other sharp object
•untreated or severe skin infections, such as cellulitis
•insect bites and stings
•a wound that requires stitches
•infected surgical wounds
•sporotrichosis, a fungal skin infection common among gardeners
Lymphangitis most often results from an acute streptococcal infection of the skin. Less often, it is caused by
a staphylococcal infection.
Lymphangitis may be a sign that a skin infection is getting worse. The bacteria can spread into the blood
and cause life-threatening problems.
6. RISK FACTOR
People with weak immune systems may be more vulnerable to lymphangitis. Having
certain conditions, such as diabetes, HIV, or cancer, or taking drugs that suppress the
immune system, including chemotherapy drugs, may all increase the risk of lymphangitis.
•chronic steroid use
•chickenpox
7. PATHOPHYSIOLOGY
The major function of the lymphatic system is to resorb fluid and protein from tissues and extravascular
spaces. The absence of a basement membrane beneath lymphatic endothelial cells affords the lymphatic
channels a unique permeability, allowing resorption of proteins that are too large to be resorbed by venules.
Lymphatic channels are situated in the deep dermis and subdermal tissues parallel to the veins and have a
series of valves to ensure one-way flow . Lymph drains via afferent lymphatics to regional lymph nodes and
then by efferent lymphatics to the cisterna chyli and the thoracic duct into the subclavian vein and venous
circulation.
Lymphangitis most commonly develops after cutaneous inoculation of microorganisms that invade the
lymphatic vessels and spread toward the regional lymph nodes. Organisms may invade lymphatic vessels
directly through a skin wound or an abrasion or as a complication of a distal infection.
8. SIGNS AND SYMPTOMS
People with lymphangitis may notice red streaks extending from the site of an
injury to areas where there are a lot of lymph glands, such as the armpits or groin.
Unexplained red streaks on any area of the body could also be a sign of
lymphangitis, especially in a person who has an existing skin infection.
Other symptoms of lymphangitis can include:
•a recent wound that is not healing
•feeling sick or weak
•a fever
•chills
•a headache
•low energy and loss of appetite
•swelling near an injury or the groin or armpits
9. SIGNS AND SYMPTOMS
•Fever and chills
•Enlarged and tender lymph nodes (glands) -- usually in the elbow, armpit, or
groin
•General ill feeling (malaise)
•Headache
•Loss of appetite
•Muscle aches
•Red streaks from the infected area to the armpit or groin (may be faint or
obvious)
•Throbbing pain along the affected area
Lymphangitis can spread to the blood if left untreated. This life-threatening
infection called sepsis may cause a very high fever, flu-like symptoms, and even
organ failure.
A person who feels very ill following an injury, or who has a high fever and
symptoms of lymphangitis, should seek emergency medical attention
10. DIAGNOSTIC EVALUATION
such as a biopsy to reveal the cause
of the swelling or a blood culture to
see if the infection is present in blood.
11. MANAGEMENT
cephalosporins – cephalexin at a dose of 0.5 mg for between 7 and 10 days – or extended-
spectrum penicillin. Methiciline-resistant staphylococcus aureus is common in communities and
hence the need to use improved antibiotic drugs such as trimethoprim-sulfamethoxazole for 7 to
10 days. Naficillin, oxacillin, and dicloxacillin are also effective against infections of the lymphatic
system
•pain medication
•anti-inflammatory medication acetaminophen (Tylenol) or ibuprofen (Advil).
•surgery to drain any abscesses that may have formed
•surgical debridement, or removal, of a node if it’s causing obstruction
12. MANAGEMENT
aid healing and ease the pain by using a hot compress at home. Run hot water over a
washcloth or towel and apply it to the tender area. Do this three times a day. The warmth
will promote blood flow and encourage healing. For the same reason, you might also want
to take warm showers, positioning the showerhead over the infected area.
If possible, keep the infected area elevated. This helps reduce swelling and slows the
spread of infection.
