Lymphangitis medical therapy
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[1]
- 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:
- 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:
- 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 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".