(See also Bacterial Skin Infections: Lymphadenitis.)
Lymphangitis is acute bacterial infection (usually streptococcal) of peripheral lymphatic channels.
Bacteria enter the lymphatic channels from an abrasion, wound, or coexisting infection (usually cellulitis). Patients with underlying lymphedema are at particular risk. Red, irregular, warm, tender streaks develop on an extremity and extend proximally from a peripheral lesion toward regional lymph nodes, which are typically enlarged and tender. Systemic manifestations (eg, fever, shaking chills, tachycardia, headache) may occur and may be more severe than cutaneous findings suggest. Leukocytosis is common. Bacteremia may occur. Rarely, cellulitis with suppuration, necrosis, and ulceration develops along the involved lymph channels as a consequence of primary lymphangitis.
Diagnosis is clinical. Isolation of the responsible organism is usually unnecessary. Most cases respond rapidly to antistreptococcal antibiotics (see Bacterial Skin Infections: Cellulitis).
Last full review/revision October 2007 by A. Damian Dhar, MD, JD