Lymphadenitis and lymphangitis

Lymphatic system

Staphylococcal lymphangitis

Immune system structures

Lymphadenitis and lymphangitis

Definition:

An infection of the lymph nodes (glands) and lymph channels.

Alternative Names:

Lymph node infection; Lymph gland infection; Localized lymphadenopathy

Causes, incidence, and risk factors:

The lymphatic system is a network of vessels (channels), nodes (glands) and organs. It functions as part of the immune system to protect against and fight infection, inflammation, and cancers. It also functions in the transport of fluids, fats, proteins, and other substances within the body. The lymph glands, or lymph nodes, are small structures that filter the lymph fluid. There are many white blood cells in the lymph nodes to help fight infection.

Lymphadenitis and lymphangitis are common complications of bacterial infections. Lymphadenitis involves inflammation of the lymph glands. This may occur if the glands are overwhelmed by bacteria, virus, fungi, or other organisms and infection develops within the glands. It may also occur as a result of circulating cancer cells or other inflammatory conditions. The location of the affected gland(s) is usually associated with the site of the underlying infection, tumor, or inflammation. It commonly is a result of a cellulitis or other bacteria infection (usually infection by streptococci or staphylococci).

Lymphangitis involves the lymph vessels/channels, with inflammation of the channel and resultant pain and systemic and localized symptoms. It commonly results from an acute streptococcal or staphylococcal infection of the skin (cellulitis), or from an abscess in the skin or soft tissues. Lymphangitis may suggest that an infection is progressing, and should raise concerns of spread of bacteria to the bloodstream, which can cause life-threatening infections. Lymphangitis may be confused with a clot in a vein (thrombophlebitis).

Symptoms:

LYMPHADENITIS

lymph nodes may be swollen, tender, and hard
lymph nodes feel smooth or irregular to touch, or soft and "rubbery" (fluctuant) if an abscess has formed
the skin over a node may be reddened and hot

LYMPHANGITIS

red streaks from infected area to the armpit or groin
- may be faint or obvious
throbbing pain along the affected area (common)
may involve the lymph nodes (see above)
fever of 100 to 104 degrees Fahrenheit and/or chills
individuals may have a general ill feeling (malaise), with loss of appetite, headache, and muscle aches

Signs and tests:

An examination shows affected lymph nodes and/or lymph vessels and may indicate the cause. The health care provider may look for evidence of trauma around enlarged or swollen nodes.

A biopsy and culture of the affected area or node may reveal the cause of the inflammation. Blood cultures may reveal spread of infection to the bloodstream.

Treatment:

Lymphadenitis and lymphangitis may spread within hours. Spreading to the bloodstream may be fatal. Treatment should begin promptly.

Specific antibiotics are used to control infection, when this is diagnosed as the underlying cause of lymphadenitis. Analgesics may be needed to control pain with lymphangitis. Anti-inflammatory medications may help reduce inflammation and swelling. Aspirin may be recommended as an analgesic, anti-inflammatory, and antipyretic (fever reducing) medication. (Consult the health care provider before giving aspirin to children!)

An abscess may require surgical drainage. Hot moist compresses may help to reduce inflammation and pain.

Expectations (prognosis):

Prompt treatment with antibiotics may result in complete recovery, though it may take weeks, or even months, for swelling to disappear. The amount of time until recovery occurs will vary depending on the underlying cause.

Complications:

abscess formation
cellulitis
sepsis (generalized or bloodstream infection)
fistula formation (seen with lymphadenitis due to tuberculosis)

Calling your health care provider:

Call your health care provider or go to the emergency room if symptoms indicate lymphadenitis or lymphangitis.

Prevention:

Good general health and hygiene are helpful in the prevention of any infection.

Review Date: 11/26/2001
Reviewed By: David N. Fisman, M.D., M.P.H., FRCP(C). Hamilton Department of Social and Public Health Services, and McMaster University Division of Infectious Diseases, Hamilton, Ontario, Canada. Review provided by VeriMed Healthcare Network.

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