TOC  | D-Dx    


Outlines in Clinical Medicine  on Physicians' Online 2001
A. Acute

  1. Staphylococcus - most common cause
  2. Streptococcus - often with lymphangitis

B. Chronic

  1. Mycobacterium - particularly atypicals (M. marinarum)
  2. Tularemia - Francilla tullarensis
  3. Cat Scratch Disease - Bartonella hensii
  4. Plague - Yersinia pestis
  5. Rat Bite Fever
  6. Rickettsia
  7. Fungi - especially Sporthrix schenckii
  8. Protozoa and Helminths

C. Buboes

  1. Tender, enlarged lymph nodes
  2. Lymphogranuloma Venerium - Chlamydia trachomatis
  3. Chancroid - Haemophils ducreyi
  4. Herpes Simplex Virus (HSV)
  5. Syphilis - Treponema pallidum
  6. Donavanosis - Calymmatobacterium granulomatis

A. Definitions

  1. Lymphangitis = Inflamed lymphatic channels
  2. Lymphadenitis = Inflamed lymph nodes
  3. Acute Lymphangitis
  4. Nodular Lymphangitis = Nodular subcutaneous swellings along involved lymphatic glands
  5. Swelling, erythema, ± fever

B. Etiology of Chronic Lymphangitis / Lymphadenitis

Arthropod + animal vectors account for lymphadenitis in ~60% of patients

Sporothrix schenckii

Mycobacteria - "Scrofula"

  1. Mycobacterium marinum - lymphangitis
  2. Mycobacterium scrofulaceum and other atypicals (lymphadenitis)

Leishmania braziliensis

Francisella tularensis

Nocardia brasiliensis - often with frank pus


C. Buboes

Means tender, enlarged lymph nodes (lymphadenitis)


Lymphogranuloma Venerium (LGV)

Granuloma Inguinale (Donovanosis)

D. Plague

Yersinia pestis

Major concern is use as a biological weapon

Incubation period 2-8 days from bite (usually be a flea)

Five cases in USA in 1996 (2 fatalities, 1 each Colorado and Arizona)

Clinical Syndromes

Bubonic Plague

Pneumonic Plague

Septicemic Plague





Obstruction or obliteration of lymphatic ducts leads to accumulation of extracellular fluid

Multiple Causes


Physical Therapy

Warfarin is not effective in patients with lymphedema after breast cancer evaluation