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. 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.