LYMPHEDEMA LYMPHANGITIS

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Lymphangitis

Related Terms: Lymph node infection; Lymph gland infection; Localized lymphadenopathy

Definition:

Infections of the lymph nodes, channels and/or sytem

An inflammation of one or more lymphatic vessels, often resulting from an acute streptococcal infection. Fine red streaks may extend from the infected area to the armpit of groin. Other signs are fever, chills, headache, over all body ache, or muscle ache. The infection may spread to the blood system, thereby becoming septic.

Symptoms:

1. Red streaks from the infected areas of involvment.

2. Throbbing, sharp pain at the site of the infection.

3. Fevers generally running from between 100' to 104'

4. Over-all aching and body pain.

Treatment:

Antibiotics for the infection and analgesics for the pain and discomfort.

Complications:

1. Extensive cellulitis

2. Septicemia

3. Pockets of septic foci

4. Possible gangrene and necrosis of tissue if left untreated

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For Further Information:

Lymphangitis

Last Updated: July 1, 2003

Synonyms and related keywords: lymphangitis, lymphangitis

Author: Raymond D Pitetti, MD, MPH, Medical Director of Fast Track, Assistant Professor, Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Pittsburgh School of Medicine

http://www.emedicine.com/ped/topic1336.htm

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Acute lymphangitis

http://www.healthatoz.com/healthatoz/Atoz/ency/acute_lymphangitis.jsp

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Acute Lymphangitis

Acute lymphangitis is inflammation of one or more lymphatic vessels, usually caused by a streptococcal infection.

Streptococci bacteria usually enter the lymphatic vessels from a scrape or wound in an arm or a leg. Often, a streptococcal infection in the skin and the tissues just beneath the skin (cellulitis) spreads to the lymph vessels. Occasionally, staphylococci or other bacteria are the cause.

Red, irregular, warm, tender streaks develop under the skin in the affected arm or leg. The streaks usually stretch from the infected area toward a group of lymph nodes, such as those in the groin or armpit. The lymph nodes become enlarged and feel tender.

Common symptoms include a fever, chills, a rapid heart rate, and a headache. Sometimes these symptoms occur before the red streaks appear. The spread of the infection from the lymph system into the bloodstream can cause infection throughout the body, often with startling speed. The skin or tissues over the infected lymph vessel becomes inflamed. Rarely, skin ulcers develop.

The diagnosis of acute lymphangitis is based on symptoms. A blood test usually shows that the number of white blood cells has increased to fight the infection. Doctors have difficulty identifying the organisms causing the infection unless the organisms have spread through the bloodstream or pus can be taken from a wound in the affected area.

Most people are cured quickly with antibiotics that kill staphylococci and streptococci, such as dicloxacillin, nafcillin, or oxacillin.

http://www.merck.com/mrkshared/mmanual_home2/sec03/ch037/ch037d.jsp

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Lymphadenitis and lymphangitis

http://www.drkoop.com/ency/article/001301.htm

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Staphylococcal Lymphangitis

Allrefer Health

Includes images

http://health.allrefer.com/health/lymphadenitis-and-lymphangitis-info.html

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Acute lymphangitis

http://www.ehendrick.org/healthy/000020.htm

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Lymphadenitis and lymphangitis

Medline Plus

Alternative names Return to top

Lymph node infection; Lymph gland infection; Localized lymphadenopathy

Definition Return to top

Lymphadenitis and lymphangitis are infection of the lymph nodes (also called lymph glands) and lymph channels, respectively.

Causes, incidence, and risk factors Return to top

The lymphatic system is a network of vessels (channels), nodes (glands) and organs. It functions as part of the immune system to protect against and fight infection, inflammation, and cancers. It also functions in the transport of fluids, fats, proteins, and other substances within the body.

The lymph glands, or nodes, are small structures that filter the lymph fluid. There are many white blood cells in the lymph nodes to help fight infection.

Lymphadenitis and lymphangitis are common complications of bacterial infections.

Lymphadenitis involves inflammation of the lymph glands. It may occur if the glands are overwhelmed by bacteria, virus, fungi, or other organisms and infection develops within the glands. It may also occur as a result of circulating cancer cells or other inflammatory conditions.

The location of the affected gland(s) is usually associated with the site of the underlying infection, tumor, or inflammation. It commonly is a result of a cellulitis or other bacteria infection (usually infection by streptococci or staphylococci).

Lymphangitis involves the lymph vessels/channels, with inflammation of the channel and resultant pain and systemic and localized symptoms. It commonly results from an acute streptococcal or staphylococcal infection of the skin (cellulitis), or from an abscess in the skin or soft tissues.

Lymphangitis may suggest that an infection is progressing, and should raise concerns of spread of bacteria to the bloodstream, which can cause life-threatening infections. Lymphangitis may be confused with a clot in a vein (thrombophlebitis).

Symptoms Return to top

LYMPHADENITIS

lymph nodes may be swollen, tender, and hard
lymph nodes feel smooth or irregular to touch, or soft and "rubbery" if an abscess has formed
the skin over a node may be reddened and hot

LYMPHANGITIS

red streaks from infected area to the armpit or groin
- may be faint or obvious
throbbing pain along the affected area (common)
may involve the lymph nodes (see above)
fever of 100 to 104 degrees Fahrenheit and/or chills
individuals may have a general ill feeling (malaise), with loss of appetite, headache, and muscle aches

Signs and tests Return to top

An examination shows affected lymph nodes and/or lymph vessels and may indicate the cause. The health care provider may look for evidence of trauma around enlarged or swollen nodes.

A biopsy and culture of the affected area or node may reveal the cause of the inflammation. Blood cultures may reveal spread of infection to the bloodstream.

Treatment Return to top

Lymphadenitis and lymphangitis may spread within hours. Treatment should begin promptly.

Specific antibiotics are used to control infection, when this is diagnosed as the underlying cause of lymphadenitis. Analgesics may be needed to control pain with lymphangitis.

Anti-inflammatory medications may help reduce inflammation and swelling. Aspirin may be recommended as an analgesic, anti-inflammatory, and fever reducer. (Consult the health care provider before giving aspirin to children!)

An abscess may require surgical drainage. Hot moist compresses may help to reduce inflammation and pain.

Expectations (prognosis) Return to top

Prompt treatment with antibiotics may result in complete recovery, though it may take weeks, or even months, for swelling to disappear. The amount of time until recovery occurs will vary depending on the underlying cause.

Complications Return to top

abscess formation
cellulitis
sepsis (generalized or bloodstream infection)
fistula formation (seen with lymphadenitis due to tuberculosis)

Calling your health care provider Return to top

Call your health care provider or go to the emergency room if symptoms indicate lymphadenitis or lymphangitis.

Prevention Return to top

Good genera
l health and hygiene are helpful in the prevention of any infection.

Update Date: 8/15/2003

Updated by: Daniel Levy, M.D., Ph.D., Infectious Diseases, Greater Baltimore Medical Center, Baltimore, MD. Review provided by VeriMed Healthcare Network

http://www.nlm.nih.gov/medlineplus/ency/article/001301.htm

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Erysipelas and lymphangitis in patients undergoing lymphedema treatment after breast-cancer therapy. Jun 2009

Pereira de Godoy JM, Azoubel LM, Guerreiro Godoy Mde F.

Source

Department of Medical School in São José do Rio Preto-FAMERP, Godoy Clinic in São José do Rio Preto-Brazil, Rua Floriano Peixoto, 2950, São José do Rio Preto-SP, 15020-010. godoyjmp@riopreto.com.br

Abstract

AIM:

The aim of this study was to evaluate the prevalence of erysipelas and lymphangitis in a group of patients under treatment for lymphedema after breast-cancer therapy.

METHODS:

A random observational prospective study of the incidences of lymphangitis and erysipelas was performed for 66 patients with arm lymphedema after breast-cancer treatment. The study was carried out between March 2006 and December 2007 at the Godoy Clinic in Sãoo José do Rio Preto, Brazil. The clinical evaluation of the participants was performed weekly before the start of treatment, with patients being required to immediately report any complications to the attending service.

RESULTS:

The mean time of follow-up of the patients between their treatment for breast cancer and the start of this study was 12.3 months, and three complications (4.5%) occurred; two cases of lymphangitis were reported after insect bites and one case of erysipelas after a hand injury, with repeat episodes reported by all three patients.

CONCLUSION:

In spite of prophylactic advice regarding lymphangitis and erysipelas during treatment for lymphedema after breast-cancer therapy, patients are subject to complications; however, this in itself does not justify the use of prophylactic antibiotic therapy.

http://www.zsd.si/ACTA/PUBLIC_HTML/acta-apa-09-2/3.pdf

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Acute lymphangitis

Definition

Acute lymphangitis is a bacterial infection in the lymphatic vessels which is characterized by painful, red streaks below the skin surface. This is a potentially serious infection which can rapidly spread to the bloodstream and be fatal.

Description

Acute lymphangitis affects a critical member of the immune system--the lymphatic system. Waste materials from nearly every organ in the body drain into the lymphatic vessels and are filtered in small organs called lymph nodes. Foreign bodies, such as bacteria or viruses, are processed in the lymph nodes to generate an immune response to fight an infection.

In acute lymphangitis, bacteria enter the body through a cut, scratch, insect bite, surgical wound, or other skin injury. Once the bacteria enter the lymphatic system, they multiply rapidly and follow the lymphatic vessel like a highway. The infected lymphatic vessel becomes inflamed, causing red streaks that are visible below the skin surface. The growth of the bacteria occurs so rapidly that the immune system does not respond fast enough to stop the infection.

If left untreated, the bacteria can cause tissue destruction in the area of the infection. A pus-filled, painful lump called an abscess may be formed in the infected area. Cellulitis, a generalized infection of the lower skin layers, may also occur. In addition, the bacteria may invade the bloodstream and cause septicemia. Lay people, for that reason, often call the red streaks seen in the skin "blood poisoning." Septicemia is a very serious illness and may be fatal.

Causes and symptoms

Acute lymphangitis is most often caused by the bacterium Streptococcus pyogenes. This potentially dangerous bacterium also causes strep throat, infections of the heart, spinal cord, and lungs, and in the 1990s has been called the "flesh-eating bacterium." Staphylococci bacteria may also cause lymphangitis.

Although anyone can develop lymphangitis, some people are more at risk. People who have had radical mastectomy (removal of a breast and nearby lymph nodes), a leg vein removed for coronary bypass surgery, or recurrent lymphangitis caused by tinea pedis (a fungal infection on the foot) are at an increased risk for lymphangitis.

The characteristic symptoms of acute lymphangitis are the wide, red streaks which travel from the site of infection to the armpit or groin. The affected areas are red, swollen, and painful. Blistering of the affected skin may occur. The bacterial infection causes a fever of 100-104°F (38-40°C). In addition, a general ill feeling, muscle aches, headache, chills, and loss of appetite may be felt.

Diagnosis

If lymphangitis is suspected, the person should call his or her doctor immediately or go to an emergency room. Acute lymphangitis could be diagnosed by the family doctor, infectious disease specialist, or an emergency room doctor. The painful, red streaks just below the skin surface and the high fever are diagnostic of acute lymphangitis. A sample of blood would be taken for culture to determine whether the bacteria have entered the bloodstream. A biopsy (removal of a piece of infected tissue) sample may be taken for culture to identify which type of bacteria is causing the infection. Diagnosis is immediate because it is based primarily on the symptoms. Most insurance policies should cover the expenses for the diagnosis and treatment of acute lymphangitis.

Treatment

Because of the serious nature of this infection, treatment would begin immediately even before the bacterial culture results were available. The only treatment for acute lymphangitis is to give very large doses of an antibiotic, usually penicillin, through the vein. Growing streptococcal bacteria are usually eliminated rapidly and easily by penicillin. The antibiotic clindamycin may be included in the treatment to kill any streptococci which are not growing and are in a resting state. Alternatively, a "broad spectrum" antibiotic may be used which would kill many different kinds of bacteria.

Aspirin or other medications which reduce the pain and the fever may also be given. Medications which reduce any inflammation of the infected region may also be provided. The patient is likely to be hospitalized to administer the antibiotic and other medications and to closely monitor his or her condition. Surgical drainage of an abscess may be necessary.

Prognosis

Complete recovery is expected if antibiotic treatment is begun at an early stage of the infection. However, if untreated, acute lymphangitis can be a very serious and even deadly disease. Acute lymphangitis that goes untreated can spread, causing tissue damage. Extensive tissue damage would need to be repaired by plastic surgery. Spread of the infection into the bloodstream could be fatal.

Prevention

Although acute lymphangitis can occur in anyone, good hygiene and general health may help to prevent infections.

Key Terms

iopsy: The process which removes a sample of diseased or infected tissue for microscopic examination to aid in diagnosis.
Lymphatic system: A component of the immune system consisting of vessels and nodes. Waste materials from organs drain into the lymphatic vessels and are filtered by the lymph nodes.
Septicemia: Disease caused by the presence and growth of bacteria in the bloodstream.

For Your Information

Periodicals

Dajer, Tony. "A Lethal Scratch." Discover (Feb. 1998): 34-7.

Source: Gale Encyclopedia of Medicine, Published December, 2002 by the Gale Group

The Essay Author is Belinda Rowland PhD.

http://www.healthatoz.com/healthatoz/Atoz/ency/acute_lymphangitis.jsp

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