Lymphangitis medical therapy: Difference between revisions
Line 36: | Line 36: | ||
===Acute Lymphangitis=== | ===Acute Lymphangitis=== | ||
====Empiric Therapy==== | ====Empiric Therapy==== | ||
<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font><ref name=" | <SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font><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><ref name="pmid23466022">{{cite journal| author=Moran GJ, Abrahamian FM, Lovecchio F, Talan DA| title=Acute bacterial skin infections: developments since the 2005 Infectious Diseases Society of America (IDSA) guidelines. | journal=J Emerg Med | year= 2013 | volume= 44 | issue= 6 | pages= e397-412 | pmid=23466022 | doi=10.1016/j.jemermed.2012.11.050 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23466022 }} </ref><ref name="pmid21208910">{{cite journal| author=Liu C, Bayer A, Cosgrove SE, Daum RS, Fridkin SK, Gorwitz RJ et al.| title=Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children. | journal=Clin Infect Dis | year= 2011 | volume= 52 | issue= 3 | pages= e18-55 | pmid=21208910 | doi=10.1093/cid/ciq146 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21208910 }} </ref></SMALL> | ||
{| | {| | ||
Line 201: | Line 201: | ||
====Pathogen Based Therapy==== | ====Pathogen Based Therapy==== | ||
<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font><ref name=" | <SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font><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<ref name="pmid23466022">{{cite journal| author=Moran GJ, Abrahamian FM, Lovecchio F, Talan DA| title=Acute bacterial skin infections: developments since the 2005 Infectious Diseases Society of America (IDSA) guidelines. | journal=J Emerg Med | year= 2013 | volume= 44 | issue= 6 | pages= e397-412 | pmid=23466022 | doi=10.1016/j.jemermed.2012.11.050 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23466022 }} </ref><ref name="pmid21208910">{{cite journal| author=Liu C, Bayer A, Cosgrove SE, Daum RS, Fridkin SK, Gorwitz RJ et al.| title=Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children. | journal=Clin Infect Dis | year= 2011 | volume= 52 | issue= 3 | pages= e18-55 | pmid=21208910 | doi=10.1093/cid/ciq146 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21208910 }} </ref>></SMALL> | ||
{| | {| |
Revision as of 14:27, 11 June 2014
Lymphangitis Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Lymphangitis medical therapy On the Web |
American Roentgen Ray Society Images of Lymphangitis medical therapy |
Risk calculators and risk factors for Lymphangitis medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vendhan Ramanujam M.B.B.S [2]
Overview
Lymphangitis most often is an acute complication following an extension from the skin infection with the potential of a systemic spread. It has to be promptly treated with appropriate antibiotics along with analgesics, anti inflammatory medications, warm and moist compresses.
Principles of Therapy
- Prompt empirical antibiotic therapy that mostly covers beta-hemolytic streptococci should be started in order to prevent the rapid progression of lymphangitis.
- If the patients do not respond to the initial empirical antibiotic therapy or present with a systemic toxicity, then empiric coverage to methicillin-resistant staphylococcus aureus (MRSA) should be considered.
- Patients with mild to moderate disease can be managed in an outpatient setting and patients with severe disease should be managed in an inpatient setting.
- While treating the patients with antibiotics, the following should be considered
- Carbapenems should not be used in patients with a history of hypersensitivity to beta-lactams.
- TMP-SMX is not recommended for women in the third trimester of pregnancy and in children under 2 months of age.
- Tetracyclines should not be used in children under 8 years of age.
- Besides antibiotics, analgesics, anti inflammatory medications, hot and moist compresses can be used to control pain and inflammation.
- Chronic sporotrichoid form of lymphangitis can be treated with chemotherapy.
- Recurrent lymphangitis can lead to chronic lymphedema, which can be treated with leg elevation, intermittent pneumatic compressions, manual massages, and multilayered bandage wrapping.
- Lymphatic filariasis can be treated with a one-day or a 12-day diethylcarbamazine regimen. The one-day regimen is as effective as the 12-day regimen.
- Findings of severe disease are:[1]
- Hypotention
- C reactive protein over 13 mg/L
- CBC with marked left shift
- Elevated creatinine level
- 2 to 3 times the upper level of normal creatinine phosphokinase
- Low bicarbonate level
- Signs suggestive of severe infection:[1]
- Cutaneous hemorrhage
- Disproportional pain
- Gas in the tissue
- Skin slaughin
- Violaceous bullae
Therapy Based on Clinical Form
Acute Lymphangitis
Empiric Therapy
▸ Click on the following categories to expand treatment regimens.[1][2][3]
Mild - Moderate Acute Lymphangitis ▸ Adults ▸ Children age >28 days Severe Acute Lymphangitis ▸ Adults ▸ Children age >28 days |
|
Pathogen Based Therapy
▸ Click on the following categories to expand treatment regimens.Closing </ref>
missing for <ref>
tag[3]>
Bacteria ▸ Streptococcus Pyogenes ▸ Methicillin Sensitive Staphylococcus Aureus ▸ Methicillin Resistant Staphylococcus Aureus ▸ Pasteurella Multocida |
|
Chronic Lymphangitis
Pathogen Based Therapy
▸ Click on the following categories to expand treatment regimens.[4][5][6]
Bacteria ▸ Mycobacterium Marinum Fungi ▸ Sporothrix Schenckii Parasites ▸ Brugia Malayi ▸ Wuchereria Bancrofti |
|
|
|
|
References
- ↑ 1.0 1.1 1.2 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.
- ↑ Moran GJ, Abrahamian FM, Lovecchio F, Talan DA (2013). "Acute bacterial skin infections: developments since the 2005 Infectious Diseases Society of America (IDSA) guidelines". J Emerg Med. 44 (6): e397–412. doi:10.1016/j.jemermed.2012.11.050. PMID 23466022.
- ↑ 3.0 3.1 Liu C, Bayer A, Cosgrove SE, Daum RS, Fridkin SK, Gorwitz RJ; et al. (2011). "Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children". Clin Infect Dis. 52 (3): e18–55. doi:10.1093/cid/ciq146. PMID 21208910.
- ↑ Kauffman CA, Bustamante B, Chapman SW, Pappas PG, Infectious Diseases Society of America (2007). "Clinical practice guidelines for the management of sporotrichosis: 2007 update by the Infectious Diseases Society of America". Clin Infect Dis. 45 (10): 1255–65. doi:10.1086/522765. PMID 17968818.
- ↑ Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F; et al. (2007). "An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases". Am J Respir Crit Care Med. 175 (4): 367–416. doi:10.1164/rccm.200604-571ST. PMID 17277290.
- ↑ "Parasites - Lymphatic Filariasis".