Lymphangitis

Background

• Inflammation of deep dermal/subdermal lymphatic channels
• Usually due to inoculation of skin flora through wound or cellulitis
• Non-infectious lymphangitis much less common, typically due to malignancy

Lymphangitis usually presents with streaking erethyma that may be tender to palpation, fever, and possibly tender lymphadenopathy if a concomitant lymphadenitis occurs. 

Clinical Features

• Pain
• Fever
• Streaking erythema
• Tenderness to palpation
• +/- tender lymphadenopathy

Differential Diagnosis

• Skin and Soft Tissue Infection
  • Cellulitis, especially if immunocompromised or severe infection
  • Erysipelas
• Necrotizing soft tissue infections
  • [[Necrotizing fasciitis
  • Necrotizing myositis
  • Necrotizing cellulitis
• Mycobacterium marinum
• Soft tissue infection look-alikes
  • Sporotrichosis
  • Osteomyelitis
  • Deep venous thrombosis
  • Pyomyositis

Management

• Depends on underlying case, but usually IV antibiotics, fluids, analgesia

See Also

• Skin and Soft Tissue Infection