Friday, February 24, 2012

Lymphangitis

Lymphangitis

Discussion Lymphangitis

Often confused with and called cellulitis; lymphangitis is an inflammation or infection of the lymphatic channels from an infection beginning elsewhere in the body. Due to the immuncompromised limb,lymphedema patients are quite susceptible to this infection.

Causes

Most commonly lymphangitis is caused either by the group A beta-hemolytic streptococcal bacteria or by Staph Aureus. Other bacterial causes include Pseudomonas, Aeromonas hydrophila, in the filarial regions lymphangitis is often caused by Wuchereria bancrofti.

Invasive bacteria enter throught a cut, scratch, insect bite, surgical wound or other skin injury.

Symptoms

Symptoms include red streaks extending from the primary infection sites through the affected area. These streaks may be painful and tender. Note tjat this is different then the “patches” or “splotches” of tend red areas associated with generalized cellulitis.

  • If the infection is in an arm or leg, you may have generalized limb swelling.

    Lymph nodes are usually swollen and painful.

    These symptoms may be accompanied by fever, chills, rapid hear rate and headache.

    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

Diagnosis

Diagnoses is generally achieved through the symptoms. An examination shows affected lymph nodes and/or lymph vessels and may indicate the cause.

A blood test also may be done to determine the exact pathogen, and or to determine if the bacterium has actually entered the bloodstream. Blood cultures may also reveal spread of infection to the bloodstream.

Risk Factors

Patients with any of the following disorders are more at risk for developing serious and or life threatening lymphangitis

Lymphedema,

Diabetes, immunodeficiency (of any type), Varicella (cellulitis as a complication of), chemotherapy patients, venous insufficiency or venous stasis, chronic steroid users, post surgical patients, individuals with edema and finally age may also be a factor with infants and the elderly more susceptible to infections.

Complications

Can include bacteremia, septicemia, tissue necrosis, gangrene, amputation of the affected limb, death. It should be noted also that lymphangitis causes further damage to the lymphatics and thereby makes lymphedema worse. Other complications include skin abcesses.

In compromised patients, physicians must be careful to observe for a complicating gram-negative super infection that can accompany regular gram-positive bacteria. This can occur asa result of the even further depletion of the body's immune system.

Complications may also include:

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

Treatment

Immediate treatment with appropriate antibiotics is the accepted therapy. These antibiotics can include Dicloxacillin, Cephlalexin (Keflex), Nafcillin; Bactrim; Augmentin, oxacillin.

IV antibiotics:

can include Unasyn, Gentamicin, Vancomycin.

In addition to the antibiotics, pain medication and anti-inflammatory medicines may be prescribed.

Prognosis

With early diagnosis and subsequent rapid treatment the outcome is actually excellent with the overwhelming number of patients making full recovery. In special risk groups however, there is a heightened risk of complication and morbidity.

It should also be noted that the medical literature reports secondary lymphedema can be and is caused by infections, including lymphangitis.

Related Keywords

lymphangitis, lymphangeitis, lymphangiitis, lymphatic system, inflammation of the lymphatic channels, bacteremia, cellulitis, septic thrombophlebitis, superficial thrombophlebitis, necrotizing necrotizing fasciitis, myositis, sporotrichosis

Pat

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