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 (see Section 18, Chapter 211)) 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.