The term lymphangitis( lymphangitis, lymphangitis) is an inflammation that covers the lymphatic vessels.
The disease can occur acutely and chronically, both small and large vessels are affected. Lymphangitis is a secondary disease, that is, it occurs if the body has a purulent-inflammatory process.
What is lymphangitis?
The lymphatic system in the human body performs a certain function - it protects organs and tissues from pathogenic microorganisms.
When they are introduced, lymph begins to produce immune cells that purify the blood and neutralize microbes. Thus, most of the microorganisms that are harmful to health die.
But in case of severe infection and against a background of decreased immunity, the lymphatic system becomes more vulnerable to microbes, as its barrier function decreases.
From the already existing purulent foci, bacteria and other pathogens fall into interstitial space, then they are marked in the lymphatic system and in the vascular endothelium. All this ends with the development of inflammation - lymphangitis.
Photo of hand lymphangitis
With lymphangitis, development of secondary lymphadenitis is not excluded. Inflammation of lymph vessels adversely affects the course of the underlying disease, weighting its severity and lengthening the recovery period.
Forms of
In medicine, several classifications of lymphangitis are used. By nature of inflammation, lymphangitis may be:
- Serous.
- Purulent.
In terms of severity, lymphangitis is divided into:
- Acute.
- Chronic.
Depending on the depth of development of the inflammatory reaction, lymphangitis may be:
- Deep.
- Superficial.
Depending on the size of the inflamed vessels, lymphangitis is defined as:
- Mesh( reticular). With this form of the disease, many small vessels, superficially located, are involved in the inflammatory process. Their inflammation is manifested by redness and therefore causes the appearance on the skin of a pattern in the form of a mesh.
- Stem( trunkular). Inflammatory reaction extends to one or several large-sized stem vessels.
Lymphangitis is also classified by type:
- Non-venereal lymphangitis occurs due to lymphatic stagnation in the tissues of the penis.
- The specific lymphangitis is associated with tuberculosis, syphilis or urogenital infections.
- Cancerous lymphangitis occurs as a complication of malignant lung injury.
- Carcinomatous lymphangitis appears in breast cancer in women and in lung cancer in both sexes.
Causes of
Lymphangitis develops as a secondary disease, the main pathogens of the disease are Staphylococcus aureus, Escherichia coli, Streptococcus, Proteus, and less often other pathogens of infectious diseases.
Inflammation may develop in the background:
- Infected wound.
- Abscess.
- Boil or carbuncle.
- Phlegmon.
- Panaritium.
The probability of passage of inflammation to the lymphatic vessels depends on several factors. These include the location of the primary focus of infection, the activity of pathogenic microflora, the characteristics of lymph circulation in this area.
From a primary focus, pathogenic bacteria enter first into small lymphatic vessels - capillaries, then with the current of lymph from them move to large calibrated vessels.
Inflammation of the walls of the vessels leads to swelling of the endothelium, to the appearance of a large exudate in volume, to an increase in the permeability of the walls, and probably the formation of thrombi.
At this stage, the inflammation is serous, further progression of the inflammatory reaction contributes to the formation of purulent lymphangitis. It is also possible purulent melting of already formed thrombi.
Symptoms of
The development of lymphangitis has its own characteristics in the acute and chronic period of the disease.
For an acutely developing pathology it is characteristic:
- Increase in body temperature, often it rises above 39 degrees.
- Severe chills and increased sweating.
- Headache.
- Broken, lethargic.
- Nausea.
It is more difficult to carry a purulent form of inflammation. At this type of disease, a febrile syndrome is clearly pronounced, the temperature can jump up to 40 degrees, the patient feels a strong weakness. Symptomatology of the disease is largely determined by the caliber of the vessels, their location and other factors.
In the case of reticular lymphangitis, attention can be paid to the reddening of the skin, which departs from the primary infected focus. Against the background of this reddening, the net of inflamed small vessels is clearly distinguished. The erythema zone has no clear boundaries. There is no serious soreness, the patient often complains of burning on the surface of the skin.
Truncular lymphangitis is manifested by the formation of red streaks, which originate from the site of primary inflammation and reach the regional lymph nodes.
These strings are edematous, with palpation painful, next to them the tissues are strained and feel hot. If deep vessels are affected, then there can be no visible manifestations, except for the puffiness of the limb. At palpation of this zone soreness sharply increases.
Perilymphangitis is dangerous due to the formation of a vast abscess on the site of inflamed vessels and tissues. The patient's condition worsens and there is a danger of sepsis.
Non-venereal lymphangitis is manifested by the appearance of a seal in the penis. As a rule, this inflammation lasts only a few hours, rarely days and passes by itself without medication.
The chronic form of the disease does not show pronounced clinical signs. The stagnation of lymph will gradually increase, and this will lead to an intensifying edema of the limb. There are changes in the skin, it becomes dry and rough above the zone of damage.
In advanced cases, trophic ulcers are formed, which are difficult to treat. Both acute and chronic lymphangitis is more severe in patients with diabetes mellitus, with cachexia, severe metabolic disorders, alcoholism and starvation.
Cancerous lymphangitis
Cancerous lymphangitis occurs due to metastasis of cancer cells from malignant foci in lung tissue.
This disease manifests itself as a dyspnea, development of signs of a pulmonary heart.
When cancer lymphangitis is strongly expressed respiratory failure and rapidly changing blood picture, tests show anemia.
Carrying out the roentgenogram determines the lesion of the root zones, lower and middle pulmonary fields.
When lymphangitis is never affected by the tops of the lungs, and this is an important distinctive feature of diseases from other pulmonary pathologies.
Complications of
Lymphangitis in the absence of timely therapy is complicated:
- Lymphadenitis. This term refers to the inflammation of the lymph nodes - axillary, cervical, inguinal, etc. This disease manifests itself with soreness, weakness, and fever.
- The formation of abscesses, phlegmon,
- Infection of blood - sepsis.
Chronic form of the disease is complicated by obliteration of blood vessels, violation of lymph circulation. Perhaps the development of lymphostasis and elephantiasis, that is, a persistent and pronounced increase in the size of the affected limb.
Diagnosis
The establishment of net lymphangitis does not cause particular complications. The doctor performs a visual examination and determines the localization of the primary focus of infection. But it is necessary to take into account that similar signs have such diseases as erysipelas or phlebitis.
It is more difficult to detect lymphangitis. When suspected of this form of inflammation appoint:
- Duplex scanning. It determines with lymphangitis the heterogeneity in the structure of the vessels, the presence around them of a light rim, the narrowing of the lumen. Inspected and the nearest lymph nodes for the detection of pathological changes in them.
- Computer thermography allows you to determine the prevalence of inflammation and its degree.
- A blood test shows an increase in white blood cells, an increase in ESR.With a complicated course of the disease, a blood test for sterility is necessary.
Cancerous lung lymphangitis is established by means of X-ray images. Non-venereal lymphangitis must be differentiated from urogenital infections.
Treatment of
Lymphangitis will not go away and may even intensify until the primary focus is eliminated.
If necessary, an autopsy, removal of pus and drainage of abscesses, panaritium, phlegmon is performed.
Aseptic dressings and antibiotics are prescribed by the course. Preparations are selected based on bacteriological culture data.
If lymphangitis affects the limbs, it is recommended that they be fixed so that they are in a raised position, this increases the outflow of lymph.
It is strictly forbidden to perform massages, rub the ointments only if prescribed by the doctor.
Painful sensations and inflammation in part pass through the use of drugs from NSAIDs - Nimesulide, Ibuprofen, Naise. Puffiness is eliminated by antihistamines. At the expressed intoxication the drop introduction of detoxification means is shown.
When chronic form of lymphangitis is prescribed:
- Treatment with ultraviolet and laser irradiation of blood.
- Dressings with absorbable ointments and mud packs.
- Dosage irradiation of inflammation zones.
Cancerous lymphangitis is treated with chemotherapy and radiation. In the non-venereal form of the disease, treatment is usually not required - the seal dissolves itself.
Prognosis and prevention of
Timely administration of treatment for an acute form of the disease quickly leads to complete recovery. The chronic form of the disease is treated much longer and often leads to complications.