Acute inflammation of the Iymphatics
Acute lymphangitis occurs when a deep or superficial infection, often
due to Streptococcus pyogenes or Staphylococcus aureus, spreads to
the draining lymphatics and lymph nodes (lymphadenitis) where an abscess may
form. Eventually this may progress to bacteraemia or septicaemia. The normal
signs of infection (rubor, calor, dolor) are present and a red streak is seen in
the skin along the line of the inflamed lymphatic (Fig.
17.1). The part should
be rested to reduce lymphatic drainage, elevated to reduce swelling and the
patient treated with intravenous antibiotics based upon actual or suspected
sensitivities. Failure to improve within 48 hours suggests inappropriate
antibiotic therapy, the presence of undrained pus either in the lymph nodes or
at the site of primary infection, or the presence of an underlying systemic
disorder (malignancy, immunodeficiency). The lymphatic damage caused by acute
lymphangitis may lead to recurrent attacks of infection and lymphoedema.