Merck Manual

Please confirm that you are not located inside the Russian Federation

honeypot link



Wingfield E. Rehmus

, MD, MPH, University of British Columbia

Reviewed/Revised Jun 2023
Topic Resources

Lymphangitis is infection of one or more lymphatic vessels, usually caused by streptococci.

Lymph Overview of the Lymphatic System The lymphatic system is a vital part of the immune system. It includes organs such as the thymus, bone marrow, spleen, tonsils, appendix, and Peyer patches in the small intestine that produce... read more is a fluid that oozes out of the body's tiniest blood vessels and is part of the body’s immune system Overview of the Immune System The immune system is designed to defend the body against foreign or dangerous invaders. Such invaders include Microorganisms (commonly called germs, such as bacteria, viruses, and fungi) Parasites... read more . The fluid goes between cells and brings nourishment and carries away substances such as damaged cells, cancer cells, and infectious microorganisms. All lymph passes through lymphatic vessels to strategically placed lymph nodes. Lymph nodes and specialized white blood cells in lymph nodes work to remove these substances and foreign particles from the body. (See figure .)

Streptococci bacteria can enter the lymphatic vessels, usually through 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 Cellulitis Cellulitis is a spreading bacterial infection of the skin and the tissues immediately beneath the skin. This infection is most often caused by streptococci or staphylococci. Redness, pain, and... read more Cellulitis ) spreads to the lymph vessels. Rarely, staphylococci or other bacteria are the cause.

Symptoms of Lymphangitis

Red, irregular, warm, tender streaks develop on 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 (see Lymphadenitis Lymphadenitis Lymphadenitis is infection of one or more lymph nodes, which usually become swollen and tender. (See also Overview of Bacterial Skin Infections.) Lymph is a fluid that oozes out of the body's... read more Lymphadenitis ).

Common symptoms of lymphangitis include a fever, shaking 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 (bacteremia Bacteremia Bacteremia is the presence of bacteria in the bloodstream. Bacteremia may result from ordinary activities (such as vigorous toothbrushing), dental or medical procedures, or from infections ... read more ) may cause infection throughout the body, often with startling speed.

Diagnosis of Lymphangitis

  • A doctor's evaluation

The diagnosis of lymphangitis is based on its typical appearance.

If needed, 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 to the bloodstream and can be cultured or pus can be taken from a wound in the affected area and cultured.

Treatment of Lymphangitis

  • Antibiotics

Most people recover quickly with antibiotics.

quiz link

Test your knowledge

Take a Quiz!