Lymphangitis physical examination

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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.

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

Signs Suggestive of Severe Infection Adapted from the 2005 IDSA Practice guidelines for the diagnosis and management of skin and soft-tissue infections.

• 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 area.
• 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.