Lymphangitis

The lymphatic system consists of a network of vessels, glands, and organs and functions as part of the immune system. The lymphatic system is also responsible for transporting fluids, fats, proteins, and other substances throughout the body. Lymph nodes or glands act as filters for the lymph fluid and are able to detect foreign bodies, such as bacteria or viruses. When bacteria or viruses are detected, an immune response is then triggered to fight infection.

Lymphangitis is an inflammation of the lymphatic channels that occurs as a result of an infection at a site distal to the channel. The pathogenic microorganisms invade the lymphatic vessels and spread to regional lymph nodes. Bacteria grow rapidly in the lymphatic system, resulting in inflammation of the lymphatic vessels. However, with prompt treatment, the prognosis for patients with uncomplicated lymphangitis is good.

Causes

Lymphangitis occurs when microorganisms enter the lymphatic channels directly through an abrasion or wound. It can also occur as a complication of infection. The more common causes in those with normal host defenses are the group A beta-hemolytic streptococcal species. Other offending microorganisms include Staphylococcus aureus and Pseudomonas species. The microorganisms enter the lymphatic channels, causing local inflammation and infection, producing red streaks on the skin, and then extending proximally toward regional lymph nodes.

Complications

Complications of lymphangitis include bacteremia, sepsis, cellulitis that may extend along the channels, necrosis, and ulceration. Without prompt treatment, lymphangitis caused by group A beta-hemolytic streptococci rapidly progresses to bacteremia, sepsis, and death.

Assessment Findings

Patients with lymphangitis may have a history of minor trauma to an area distal to the site of infection. The primary site may be an abscess, an infected wound, or an area of cellulitis. Upon examination, tender, warm, erythematous and irregular linear streaks extend from the primary infection site toward draining regional nodes, which are often swollen and tender. Blistering of the affected skin may also occur. In addition, the patient may be febrile and tachycardic. (See Evaluating the lymph nodes.)

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