Lymphangitis physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
Depending on etiologies lymphangitis has spectrum of physical findings.<ref name=lymphangitis>lymphanitis Mandell, GERALD L. "Mandell, Douglas, and Bennett's." Principles and practice of infectious diseases 7 (1995) Accessed on October 12,2016</ref><ref name="pmid8480962">{{cite journal| author=Kostman JR, DiNubile MJ| title=Nodular lymphangitis: a distinctive but often unrecognized syndrome. | journal=Ann Intern Med | year= 1993 | volume= 118 | issue= 11 | pages= 883-8 | pmid=8480962 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8480962 }} </ref><ref name="pmid18317034">{{cite journal| author=Schubach A, Barros MB, Wanke B| title=Epidemic sporotrichosis. | journal=Curr Opin Infect Dis | year= 2008 | volume= 21 | issue= 2 | pages= 129-33 | pmid=18317034 | doi=10.1097/QCO.0b013e3282f44c52 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18317034 }} </ref><ref name="pmid27051706">{{cite journal| author=Chung E, Pulitzer MP, Papadopoulos EB, Papanicolaou GA, Babady NE, Marchetti MA| title=Lymphangitic papules caused by Nocardia takedensis. | journal=JAAD Case Rep | year= 2015 | volume= 1 | issue= 3 | pages= 126-8 | pmid=27051706 | doi=10.1016/j.jdcr.2015.03.001 | pmc=4808715 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27051706 }} </ref><ref name="pmid11472559">{{cite journal| author=Taylor MJ, Cross HF, Ford L, Makunde WH, Prasad GB, Bilo K| title=Wolbachia bacteria in filarial immunity and disease. | journal=Parasite Immunol | year= 2001 | volume= 23 | issue= 7 | pages= 401-9 | pmid=11472559 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11472559 }} </ref><ref name="pmid20739055">{{cite journal| author=Taylor MJ, Hoerauf A, Bockarie M| title=Lymphatic filariasis and onchocerciasis. | journal=Lancet | year= 2010 | volume= 376 | issue= 9747 | pages= 1175-85 | pmid=20739055 | doi=10.1016/S0140-6736(10)60586-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20739055 }} </ref><ref name=harrison>lymphanitis "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on October 12,2016</ref><ref name="pmid8930034">{{cite journal| author=Bruce DM, Heys SD, Eremin O| title=Lymphangitis carcinomatosa: a literature review. | journal=J R Coll Surg Edinb | year= 1996 | volume= 41 | issue= 1 | pages= 7-13 | pmid=8930034 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8930034 }} </ref> | Depending on etiologies, lymphangitis has spectrum of physical findings.<ref name=lymphangitis>lymphanitis Mandell, GERALD L. "Mandell, Douglas, and Bennett's." Principles and practice of infectious diseases 7 (1995) Accessed on October 12,2016</ref><ref name="pmid8480962">{{cite journal| author=Kostman JR, DiNubile MJ| title=Nodular lymphangitis: a distinctive but often unrecognized syndrome. | journal=Ann Intern Med | year= 1993 | volume= 118 | issue= 11 | pages= 883-8 | pmid=8480962 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8480962 }} </ref><ref name="pmid18317034">{{cite journal| author=Schubach A, Barros MB, Wanke B| title=Epidemic sporotrichosis. | journal=Curr Opin Infect Dis | year= 2008 | volume= 21 | issue= 2 | pages= 129-33 | pmid=18317034 | doi=10.1097/QCO.0b013e3282f44c52 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18317034 }} </ref><ref name="pmid27051706">{{cite journal| author=Chung E, Pulitzer MP, Papadopoulos EB, Papanicolaou GA, Babady NE, Marchetti MA| title=Lymphangitic papules caused by Nocardia takedensis. | journal=JAAD Case Rep | year= 2015 | volume= 1 | issue= 3 | pages= 126-8 | pmid=27051706 | doi=10.1016/j.jdcr.2015.03.001 | pmc=4808715 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27051706 }} </ref><ref name="pmid11472559">{{cite journal| author=Taylor MJ, Cross HF, Ford L, Makunde WH, Prasad GB, Bilo K| title=Wolbachia bacteria in filarial immunity and disease. | journal=Parasite Immunol | year= 2001 | volume= 23 | issue= 7 | pages= 401-9 | pmid=11472559 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11472559 }} </ref><ref name="pmid20739055">{{cite journal| author=Taylor MJ, Hoerauf A, Bockarie M| title=Lymphatic filariasis and onchocerciasis. | journal=Lancet | year= 2010 | volume= 376 | issue= 9747 | pages= 1175-85 | pmid=20739055 | doi=10.1016/S0140-6736(10)60586-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20739055 }} </ref><ref name=harrison>lymphanitis "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on October 12,2016</ref><ref name="pmid8930034">{{cite journal| author=Bruce DM, Heys SD, Eremin O| title=Lymphangitis carcinomatosa: a literature review. | journal=J R Coll Surg Edinb | year= 1996 | volume= 41 | issue= 1 | pages= 7-13 | pmid=8930034 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8930034 }} </ref> | ||
==Physical Examination== | ==Physical Examination== | ||
*Clinical examination findings of lymphangitis are variable, depending on the etiology. History and symptoms based on the classification as follows | *Clinical examination findings of lymphangitis are variable, depending on the etiology. History and symptoms based on the classification as follows: | ||
===Lymphangitis due to infectious etiology=== | ===Lymphangitis due to infectious etiology=== | ||
====Common physical examination findings of | ====Common physical examination findings of acute lymphangitis==== | ||
*Fever | *Fever | ||
*Red streaks from the infected area to the regional lymph node | *Red streaks from the infected area to the regional lymph node | ||
| Line 20: | Line 19: | ||
</gallery> | </gallery> | ||
</div> | </div> | ||
=====Signs | =====Signs suggestive of severe infection <small><small><small><small>'''Adapted from the 2005 IDSA Practice guidelines for the diagnosis and management of skin and soft-tissue infections.'''<ref name="pmid16231249">{{cite journal| author=Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ et al.| title=Practice guidelines for the diagnosis and management of skin and soft-tissue infections. | journal=Clin Infect Dis | year= 2005 | volume= 41 | issue= 10 | pages= 1373-406 | pmid=16231249 | doi=10.1086/497143 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16231249 }} </ref></small></small></small></small>===== | ||
*[[Hypotension]] | *[[Hypotension]] | ||
*Cutaneous hemorrhage | *Cutaneous hemorrhage | ||
| Line 27: | Line 26: | ||
*Skin sloughing | *Skin sloughing | ||
*Violaceous bullae | *Violaceous bullae | ||
====Common physical examination findings of chronic granulomatous lymphangitis==== | |||
====Common physical examination findings of | |||
*Painful or painless nodular subcutaneous swellings along the course of the lymphatic channels | *Painful or painless nodular subcutaneous swellings along the course of the lymphatic channels | ||
*Tender lymph nodes | *Tender lymph nodes | ||
====Common physical examination findings of | ====Common physical examination findings of filarial lymphangitis==== | ||
*Fever | *Fever | ||
*Lymphatic inflammation | *Lymphatic inflammation | ||
**Tender lymph nodes | **Tender lymph nodes | ||
**Lymphangitis is retrograde, extending peripherally from the lymph node draining | **Lymphangitis is retrograde, extending peripherally from the lymph node draining are. | ||
*Transient lymph edema | *Transient lymph edema | ||
===Lymphangitis due to infectious etiology=== | ===Lymphangitis due to infectious etiology=== | ||
| Line 41: | Line 39: | ||
*Cyanosis | *Cyanosis | ||
*Signs of pulmonary hypertension | *Signs of pulmonary hypertension | ||
*Auscultation reveals moist or dry crackles | *Auscultation reveals moist or dry crackles | ||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Inflammations]] | [[Category:Inflammations]] | ||
[[Category:Infectious disease]] | [[Category:Infectious disease]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Signs and symptoms]] | [[Category:Signs and symptoms]] | ||
Revision as of 00:41, 24 October 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vendhan Ramanujam M.B.B.S [2]Vishal Devarkonda, M.B.B.S[3]
Overview
Depending on etiologies, lymphangitis has spectrum of physical findings.[1][2][3][4][5][6][7][8]
Physical Examination
- Clinical examination findings of lymphangitis are variable, depending on the etiology. History and symptoms based on the classification as follows:
Lymphangitis due to infectious etiology
Common physical examination findings of acute lymphangitis
- Fever
- Red streaks from the infected area to the regional lymph node
- Tender lymph nodes
-
Lymphangitis of the Arm -
Lymphangitis of the Arm
Signs suggestive of severe infection Adapted from the 2005 IDSA Practice guidelines for the diagnosis and management of skin and soft-tissue infections.[9]
- Hypotension
- Cutaneous hemorrhage
- Disproportional pain
- Gas in the tissue
- Skin sloughing
- Violaceous bullae
Common physical examination findings of chronic granulomatous lymphangitis
- Painful or painless nodular subcutaneous swellings along the course of the lymphatic channels
- Tender lymph nodes
Common physical examination findings of filarial lymphangitis
- Fever
- Lymphatic inflammation
- Tender lymph nodes
- Lymphangitis is retrograde, extending peripherally from the lymph node draining are.
- Transient lymph edema
Lymphangitis due to infectious etiology
Common physical examination findings Lymphangitis carcinomatosa
- Cyanosis
- Signs of pulmonary hypertension
- Auscultation reveals moist or dry crackles
References
- ↑ lymphanitis Mandell, GERALD L. "Mandell, Douglas, and Bennett's." Principles and practice of infectious diseases 7 (1995) Accessed on October 12,2016
- ↑ Kostman JR, DiNubile MJ (1993). "Nodular lymphangitis: a distinctive but often unrecognized syndrome". Ann Intern Med. 118 (11): 883–8. PMID 8480962.
- ↑ Schubach A, Barros MB, Wanke B (2008). "Epidemic sporotrichosis". Curr Opin Infect Dis. 21 (2): 129–33. doi:10.1097/QCO.0b013e3282f44c52. PMID 18317034.
- ↑ Chung E, Pulitzer MP, Papadopoulos EB, Papanicolaou GA, Babady NE, Marchetti MA (2015). "Lymphangitic papules caused by Nocardia takedensis". JAAD Case Rep. 1 (3): 126–8. doi:10.1016/j.jdcr.2015.03.001. PMC 4808715. PMID 27051706.
- ↑ Taylor MJ, Cross HF, Ford L, Makunde WH, Prasad GB, Bilo K (2001). "Wolbachia bacteria in filarial immunity and disease". Parasite Immunol. 23 (7): 401–9. PMID 11472559.
- ↑ Taylor MJ, Hoerauf A, Bockarie M (2010). "Lymphatic filariasis and onchocerciasis". Lancet. 376 (9747): 1175–85. doi:10.1016/S0140-6736(10)60586-7. PMID 20739055.
- ↑ lymphanitis "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on October 12,2016
- ↑ Bruce DM, Heys SD, Eremin O (1996). "Lymphangitis carcinomatosa: a literature review". J R Coll Surg Edinb. 41 (1): 7–13. PMID 8930034.
- ↑ Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ; et al. (2005). "Practice guidelines for the diagnosis and management of skin and soft-tissue infections". Clin Infect Dis. 41 (10): 1373–406. doi:10.1086/497143. PMID 16231249.