Acute lymphangitis is an inflammatory process involving the subcutaneous lymphatic channels. It is due most often to group A streptococcus (GAS) but occasionally may be caused by Staphylococcus aureus; rarely, soft tissue infections with other organisms, such as Pasteurella multocida herpes simplex virus may be associated with acute lymphangitis.
Causes of Acute Lymphangitis
- 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.
- Staphylococci bacteria may also cause lymphangitis.
- In immunocompromised hosts, gram-negative rods, gram-negative bacilli, and fungi may cause cellulitis and resultant lymphangitis.
- Children with diabetes, immunodeficiency, varicella, chronic steroid use, or other systemic illnesses have increased risk of developing serious or rapidly spreading lymphangitis.
Symptoms of Acute Lymphangitis
- fever
- chills
- a rapid heart rate
- a headache
- Rash
- Red blotchy skin
- Itching of the affected area
- Discoloration
- Increase of swelling and/or temperature of the skin
- Heavy sensation in the limb (more so than usual)
- Pain
- In many cases a sudden onset of high fever and chills
Diagnosis
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. The combination of a peripheral lesion with proximal red linear streaks leading toward regional lymph nodes is diagnostic of lymphangitis.
Treatment
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.
Prevention
Although acute lymphangitis can occur in anyone, good hygiene and general health may help to prevent infections.
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