Lymphangitis physical examination: Difference between revisions

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==Overview==
==Overview==
Depending on etiologies, lymphangitis has spectrum of physical findings. Specific physical examination findings for individual infections are discussed in detail separately.<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>
Lymphangitis being a manifestation of wide concurrently occurring spectrum of manifestations or pathologies.The history and symptoms varies from etiology to etiology.
 
Physical examination findings for individual infections are discussed in detail separately.
 
==Physical Examination==
==Physical Examination==
*Clinical examination findings of lymphangitis are variable, depending on the etiology. History and symptoms based on the classification as follows:
Lymphangitis being a manifestation of wide concurrently occurring spectrum of manifestations or pathologies.The history and symptoms varies from etiology to etiology. Commonly associated history and symptoms with different forms of etiology include:<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>
 
===Lymphangitis due to infectious etiology===
===Lymphangitis due to infectious etiology===
====Common physical examination findings of acute lymphangitis====
====Common physical examination findings of acute lymphangitis====
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*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 filarial lymphangitis====
====Physical examination findings of filarial lymphangitis, please [http://www.wikidoc.org/index.php/Filariasis_physical_examination click here]====
*Fever
===Lymphangitis due to Non-infectious etiology===
*Lymphatic inflammation
====Lymphangitis carcinomatosa====
**Tender lymph nodes
Common physical examination findings assoicated with lymphangitis carcinomatosa:<ref name="pmid89300342">{{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>
**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  
*Cyanosis  
*Signs of pulmonary hypertension
*Signs of pulmonary hypertension
*Auscultation reveals moist or dry crackles
*Auscultation reveals moist or dry crackles
====Sclerosing lymphangitis====
====Sclerosing lymphangitis====
Examination findings of patient with sclerosing lymphangitis include:
Physical examination findings of sclerosing lymphangitis include:<ref name="pmid26228831">{{cite journal| author=Papeš D, Altarac S, Antabak A, Savić I| title=Nonvenereal sclerosing lymphangitis of the penis. | journal=Acta Dermatovenerol Croat | year= 2015 | volume= 23 | issue= 2 | pages= 150-1 | pmid=26228831 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26228831  }}</ref>
* A cordlike elevated strand 4 to 7 mm. wide which encircle the penile shaft.
* A cordlike elevated strand 4 to 7 mm. wide which encircle the penile shaft.
* Palpation: the lesion was freely mobile and firm in consistency.
* Palpation: the lesion was freely mobile and firm in consistency.

Revision as of 17:50, 2 January 2017

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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

Lymphangitis being a manifestation of wide concurrently occurring spectrum of manifestations or pathologies.The history and symptoms varies from etiology to etiology.

Physical examination findings for individual infections are discussed in detail separately.

Physical Examination

Lymphangitis being a manifestation of wide concurrently occurring spectrum of manifestations or pathologies.The history and symptoms varies from etiology to etiology. Commonly associated history and symptoms with different forms of etiology include:[1][2][3][4][5][6][7][8]

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

  • 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

Physical examination findings of filarial lymphangitis, please click here

Lymphangitis due to Non-infectious etiology

Lymphangitis carcinomatosa

Common physical examination findings assoicated with lymphangitis carcinomatosa:[10]

  • Cyanosis
  • Signs of pulmonary hypertension
  • Auscultation reveals moist or dry crackles

Sclerosing lymphangitis

Physical examination findings of sclerosing lymphangitis include:[11]

  • A cordlike elevated strand 4 to 7 mm. wide which encircle the penile shaft.
  • Palpation: the lesion was freely mobile and firm in consistency.
  • On incision of the lesion a yellow-brown cord with multiple bulbous formations could be seen under the skin.

References

  1. ↑ lymphanitis Mandell, GERALD L. "Mandell, Douglas, and Bennett's." Principles and practice of infectious diseases 7 (1995) Accessed on October 12,2016
  2. ↑ Kostman JR, DiNubile MJ (1993). "Nodular lymphangitis: a distinctive but often unrecognized syndrome". Ann Intern Med. 118 (11): 883–8. PMID 8480962.
  3. ↑ Schubach A, Barros MB, Wanke B (2008). "Epidemic sporotrichosis". Curr Opin Infect Dis. 21 (2): 129–33. doi:10.1097/QCO.0b013e3282f44c52. PMID 18317034.
  4. ↑ 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.
  5. ↑ 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.
  6. ↑ 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.
  7. ↑ 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
  8. ↑ Bruce DM, Heys SD, Eremin O (1996). "Lymphangitis carcinomatosa: a literature review". J R Coll Surg Edinb. 41 (1): 7–13. PMID 8930034.
  9. ↑ 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.
  10. ↑ Bruce DM, Heys SD, Eremin O (1996). "Lymphangitis carcinomatosa: a literature review". J R Coll Surg Edinb. 41 (1): 7–13. PMID 8930034.
  11. ↑ Papeš D, Altarac S, Antabak A, Savić I (2015). "Nonvenereal sclerosing lymphangitis of the penis". Acta Dermatovenerol Croat. 23 (2): 150–1. PMID 26228831.
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