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What is lymphangitis?
Lymphangitis is a condition resulting in inflamed lymphatic vessels due to an infection. The lymphatic system runs throughout the body and consists of both nodes and these vessels. The nodes produce lymph — the clear fluid that bathes and nourishes the organs and other tissues — while the vessels circulate the lymph throughout the body.
Symptoms include swelling, often under the arm or at the bend of the elbow, red streaks in the skin that may stem from the armpit or groin and may be bright red or painful, as well as a fever with chills, a headache, or a general ill feeling all over.
If recognized quickly, lymphangitis can often be successfully treated with antibiotics and over-the-counter medication to soothe pain. In more severe cases, lymphangitis can lead to widespread infection and shock known as sepsis. Surgery or other intervention may be required.
Seek urgent care immediately. The physician will likely take sample of lymph fluid to test for the cause of inflammation.
The main symptoms of lymphangitis include the following.
- Swelling: Swelling may be present and sometimes painful. Areas of swelling may include under the arm, at the bend of the elbow, or in the groin and lower abdominal area.
- Red streaks in the skin: Red streaks leading from the site of the skin infection to the armpit or the groin. These streaks may be pale or bright red, painful and throbbing, or hot to the touch.
- Other symptoms include: You may also experience a fever with chills, a headache, or a general ill-feeling and/or ache all over.
Causes of lymphangitis are described below, including infectious agents, breaks in the skin, untreated bacterial infections, a suppressed immune system, as well as related and similar causes of your symptoms.
Infectious agents that can contribute to this condition include:
- Bacteria: This includes bacteria commonly found on the skin, such as Streptococcus bacteria and Staphylococcus bacteria.
- Certain types of fungus
Breaks in the skin
A break in the skin of any kind, anywhere on the body, can allow the normal bacteria on the skin to enter and cause an infection. These include:
- Cuts or scratches
- Severely dry, cracked, or peeling skin
- Puncture wounds
- Surgical wounds
- Insect stings or bites
- Ulcerations: Sores on the skin from conditions such as diabetes, circulatory disease, or bedsores can lead to lymphangitis.
Untreated bacterial infections
If left untreated, a bacterial infection that takes hold on any broken skin can spread to the lymphatic system. These include:
- An abscess: Also known as a boil, this is a painful, reddened, pus-filled lump on top of the skin.
- Cellulitis: This is a sore and reddened infection of the middle layer of the skin and can affect the layers below it.
Suppressed immune system
Having a suppressed immune system allows bacteria to gain a foothold within the body. This can include:
- Overall poor health: Being in poor condition, such as being weak or debilitated from other illness, malnourished, or in an overstressed state can lead to lymphangitis.
- Immune disorders: Illnesses that directly affect the immune system include HIV/AIDS.
- Medications: Being on certain medications such as corticosteroids or chemotherapy drugs can lead to lymphangitis.
Related and similar causes
There are several related or similar conditions not to be confused with lymphangitis. They include:
- Lymphadenitis: This is a bacterial infection of only lymph nodes, while lymphangitis is a bacterial infection of only the lymph vessels. However, lymphadenitis of at least one or more nearby lymph nodes is usually found at the same time as lymphangitis.
- Lymphadenopathy: This refers to chronically enlarged lymph nodes. The cause may be bacterial but there are others, including viral illnesses, certain medications, and tumors.
- Lymphedema: This is swelling in the arms or legs caused by a failure of the lymphatic system to drain properly. It is not caused by bacteria and is not the same as lymphangitis.
- Sepsis: Sepsis, or bloodstream infection, is sometimes confused with lymphangitis because of the red streaks that appear on the skin in both situations. Sepsis can be a complication of lymphangitis.
- Thrombophlebitis: Thrombophlebitis is inflammation of the veins due to a blood clot, and also has reddened streaks as one of its symptoms. However, it is not related to lymphangitis.
Lymphangitis treatment options and prevention
Lymphangitis is an acute condition and usually a one-time incident that can be treated with no lasting effects. The main treatments that will likely be recommended by your physician include the following; however, there are several preventative methods and details regarding hygiene you should practice to remain in good health.
- Antibiotics: This condition may be treated with antibiotics, either orally or intravenously. Antibiotics may be given via a one-time injection (intramuscularly or IM) or through an intravenous route (IV).
- Over-the-counter medication: This includes non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) to ease the pain, inflammation, and swelling. Additional pain medication may be taken if needed.
- Warm compresses: Warm compresses applied to the skin help break up the pockets of infection and therefore reduce pain and inflammation.
- Surgery: Surgery may be recommended if the skin infection becomes an abscess.
The following ways are the best defense against developing lymphangitis.
- Treat bacterial skin infections: Lymphangitis is nearly always caused by a bacterial infection that starts on the skin but is left untreated.
- Pay attention to breaks in the skin: When there is a break in the skin, the infection is able to get into the lymphatic vessels. Once in the lymphatic vessels, the bacteria will continue to grow and may further spread into the lymph nodes. From the lymphatic system, the infection can get into the bloodstream, and from there, spread throughout the body.
Be mindful of hygiene
Normal skin has a number of different types of bacteria on it. However, these bacteria can quickly multiply if the skin is not kept clean through daily bathing and frequent handwashing or the skin is exposed to more dirt than usual. Be mindful of the following situations and associative hygiene:
- Hard physical work: This especially includes work that involves exposure to dirt, plants, and animals. All of those also carry bacteria and some types of fungus.
- Being outdoors for longer periods: Camping or hiking for long periods does not often provide many chances for proper washing.
- Living in harsh conditions: This includes going through a disaster with floodwaters or debris. Anyone working in a disaster zone, such as a first responder or volunteer, is also vulnerable.
If antibiotics are given without delay, the infection, inflammation, and redness will usually clear up within a few days. However, swelling in the lymph nodes (especially under the arm and in the groin), and in the affected lymphatic vessels, can take weeks or months to subside and finally return to normal. Of course, the underlying cause must be treated as well so that the lymphangitis does not come back. This involves:
- Good hygiene: This will treat the overgrowth of bacteria or fungus on the skin.
- Treating breaks in the skin: You should use the right antiseptic cream or ointment and bandage it correctly until it has had the chance to fully heal.
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When to seek further consultation for lymphangitis
If left untreated, the same bacteria that infected the lymphatic system can spread to the bloodstream. From there the infection can invade nearly any organ in the body.
This widespread, systemic bacterial infection can quickly overwhelm the body's defenses and cause sepsis. Sepsis can be life-threatening.
Lymphangitis can spread very quickly. In less than a day, it can become a medical emergency.
If the red streaks begin to spread
Once red streaks are seen leading away from the site of the broken skin or abscess, the condition is becoming serious and should be seen by a medical provider as soon as possible.
If you are being treated
If treated right away, the condition can usually be cleared up with antibiotics.
Questions your doctor may ask to determine lymphangitis
- Are you sick enough to consider going to the emergency room right now?
- Have you lost your appetite recently?
- Do you have a sore throat?
- Have you experienced any nausea?
- How severe is your fever?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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- U.S. National Library of Medicine: MedlinePlus. Updated December 6, 2018. MedlinePlus Link
- Vindenes T, McQuillen D. Acute lymphangitis. The New England Journal of Medicine. 2015;372:649. NEJM Link
- Cohen BE, Nagler AR, Pomeranz MK. Nonbacterial causes of lymphangitis with streaking. J Am Board Fam Med. 2016;29(6):808-812. NCBI Link
- Fairview Health Services. Fairview Health Services Link
- Sepsis and cellulitis. Sepsis Alliance. Updated December 13, 2017. Sepsis Alliance Link