Lymphangitis
Basics
Description
Description
- Lymphangitis is the infection of lymphatics that drain a focus of inflammation or other infection
- Histologically, lymphatic vessels are dilated and filled with lymphocytes and histiocytes
Etiology
Etiology
- Acute lymphangitis:
- Caused by bacterial infection
- Most common: Group A β-hemolytic Streptococcus
- Less common: Other strep species, methicillin-sensitive Staphylococcus aureus (MSSA) and methicillin-resistant S. aureus (MRSA):
- Risk factors for Staph infection (MSSA and MRSA):
- Recent hospital or long-term care admission
- Recent surgery
- Children
- Soldiers
- Incarcerated persons
- Athletes in contact sport
- Injection drug use
- Men who have sex with men
- Dialysis treatments and catheters
- History of penetrating trauma
- Additional risk factors for MRSA infection:
- Prior MRSA infection
- MRSA colonization
- Area of high MRSA incidence
- Close contact with MRSA patient
- Risk factors for Staph infection (MSSA and MRSA):
- Other organisms:
- Pasteurella multocida (cat or dog bite)
- Streptobacillus moniliformis (rat-bite fever)
- Wuchereria bancrofti (filariasis): Mosquito borne
- Consider in immigrants from Africa, Southeast Asia/Pacific, and tropical South America with lower-extremity involvement
- Chronic (nodular) lymphangitis:
- Usually caused by mycotic, mycobacterial, and filarial infections
- Sporothrix schenckii (most common cause of chronic lymphangitis in the U.S.):
- Inoculation occurs while gardening or farming (rose thorn)
- Organism is present on some plants and in sphagnum moss
- Multiple SC nodules appear along course of lymphatic vessels
- Typical antibiotics and local treatment fail to cure lesion
- Mycobacterium marinum:
- Atypical Mycobacterium
- Grows optimally at 25–32°C in fish tanks and swimming pools
- May produce a chronic nodular, single wart-like or ulcerative lesion at site of abrasion
- Additional lesions may appear in distribution similar to sporotrichosis
- Nocardia brasiliensis
- Mycobacterium kansasii
- W. bancrofti
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Citation
Schaider, Jeffrey J., et al., editors. "Lymphangitis." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307392/all/Lymphangitis.
Lymphangitis. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307392/all/Lymphangitis. Accessed October 6, 2024.
Lymphangitis. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307392/all/Lymphangitis
Lymphangitis [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 October 06]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307392/all/Lymphangitis.
* Article titles in AMA citation format should be in sentence-case
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BT - 5-Minute Emergency Consult
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