Inflammation of the lymphatic vessels, lymphangitis manifests in several areas of the body as red, hot and painful streaks. Its cause is the penetration of germs through small wounds on the skin which are all entry points for infection. 

Lymphangitis is a localized inflammation of lymphatic vessels in which lymph usually circulates, which is a colorless or slightly yellowish liquid similar to blood serum. It contains white blood cells, but no red blood cells. Eight to ten liters of lymph are present in the body, bathing all the organs and tissues of the body. Organs like the spleen, thymus, tonsils are part of this lymphatic system.

All of the lymphatic vessels present lymph nodes which form the nodes. Along with the veins and arteries in which blood circulates, the lymphatic vessels with their nodes allow the circulation of lymph throughout the body. The function of this lymphatic system is to defend the organism against external attacks such as viruses and bacteria.

The occurrence of lymphangitis makes it possible to mobilize the immune defenses to fight against an infection by an inflammatory reaction of the lymphatic vessels downstream of the entry point of the infection (wound). This inflammatory reaction is associated with swelling of the lymph nodes to prevent the rise of the microbe in the body.

The onset of lymphangitis is manifested by a red cord under the skin (truncal lymphangitis), running from the wound along the lymphatic vessels up to the heart. The nearby lymph nodes will be affected to fight against the rise of the infection, they will swell and become painful. Lymphangitis is common in the legs or arms, from a wound in the feet and hands, and sometimes higher above the feet or in the forearm.

They are also present in the breasts during breastfeeding through small wounds in the nipple with the occurrence of reticular inflammatory cords (network) and more generally swelling of the breast which becomes painful. More rarely, lymphangitis can affect the eyelids with a sore on the face, penis and bursae (scrotum) associated with significant local edema.

The symptoms of lymphangitis regardless of its location are:

• inflammation in the course of the lymphatic vessel;
• pain along lymphangitis, spontaneous or on pressure;
• local swelling (edema);
• local redness;
• fever at 38.5 / 39;
• headache (headache);
• chills associated with the passage of the germ in the blood (onset of sepsis);
• swollen and painful nodes along the path of the lymphangitis (lymphadenopathy).

If lymphangitis is not treated quickly, it can progress to more serious forms with the appearance of pus in small abscesses along the path of the lymphatic vessel, and sepsis (microbes passing into the blood)

The most common cause, regardless of the location of lymphangitis is a wound, sometimes small, upstream of the lymphangitis cord (foot, hands) or around the nipple, penis and genitals with reticulated lymphangitis. This sore can be linked to:

• even a slight injury;
• an insect bite;
• a furoncle;
• skin infection (erysipelas);
• a dirty needle;
• cutaneous yeast infections which alter the protective barrier of the skin;
• animal bites or scratches like that of a cat (cat scratch disease).

Diabetes, poor blood circulation (venous insufficiency with varicose veins) are factors favoring the occurrence of lymphangitis. This skin breakage, whatever the cause, allows germs to enter the tissues which will try to reach the heart. The germs frequently involved in lymphangitis are most often streptococcus, and more rarely staphylococcus, the herpes virus, rickettsioses, mycoplasmas, etc.

Finally, there is a rarer form of lymphangitis, carcinomatous lymphangitis, which is linked to the migration of cancer cells by the lymphatic system to tissues such as lymph nodes, lungs, liver and brain to metastasize.

The diagnosis is most often established from the clinical examination (search for inflammatory cords, lymph nodes, an enlarged spleen, etc.) and the anamnesis of the history of the disease (sting, scratching , bite, fever, chills, etc.).

A biological assessment will show an increase in the number of white blood cells, inflammation of the body (VS, CRP), a positive serology for cat scratch disease, etc.

The treatment, which must be implemented quickly, is based on general and local antibiotic therapy. In the presence of signs of sepsis, a blood sample will identify the germ in question and adapt the antibiotic therapy.

Finally, preventive measures can be implemented upstream, such as putting on gloves or boots when there is a risk of wounds, scratches or bites.