Lymphangitis

The lymph system is a network of lymph nodes, lymph ducts, lymph vessels, and organs that produce and move a fluid called lymph from tissues to the bloodstream.

Lymphangitis most often results from an acute streptococcal infection of the skin. Less often, it is caused by a staphylococcal infection. The infection causes the lymph vessels to become inflamed.

Lymphangitis may be a sign that a skin or soft tissue infection is getting worse. The bacteria can spread further into the blood and cause life-threatening problems.

Symptoms may include:

• Fever and chills
• Enlarged and tender lymph nodes (glands) -- usually in the elbow, armpit, or groin
• General ill feeling (malaise)
• Headache
• Loss of appetite
• Muscle aches
• Red streaks from the infected area to the armpit or groin (may be faint or obvious)
• Throbbing pain along the affected area

Your health care provider will perform a physical exam, which includes feeling your lymph nodes and examining your skin. The provider may look for signs of injury around swollen lymph nodes.

A biopsy and culture of the affected area may reveal the cause of the inflammation. A blood culture may be done to see if the infection has spread to the blood.

Lymphangitis may spread within hours. Treatment should begin right away.

Treatment may include:

• Antibiotics by mouth or IV (through a vein) to treat any infection
• Pain medicine to control pain
• Anti-inflammatory medicines to reduce inflammation and swelling
• Cool compresses to reduce inflammation and pain

Surgery may be needed to drain an abscess.

Prompt treatment with antibiotics usually leads to a complete recovery. It may take weeks, or even months, for swelling to disappear. The amount of time it takes to recover depends on the cause.

Health problems that may occur include:

• Abscess (collection of pus)
• Cellulitis (a skin infection)
• Sepsis (a general or bloodstream infection)

Contact your provider or go to the emergency room if you have symptoms of lymphangitis.

Inflamed lymph vessels; Inflammation - lymph vessels; Infected lymph vessels; Infection - lymph vessels

Pasternack MS, Swartz MN. Lymphadenitis and lymphangitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 95.

Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL, Hirschmann JV, Kaplan SL, Montoya JG, Wade JC; Infectious Diseases Society of America. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014 Jul 15;59(2):e10-52. Erratum in: Clin Infect Dis. 2015 May 1;60(9):1448. Dosage error in article text. PMID: 24973422. pubmed.ncbi.nlm.nih.gov/24973422/.

Updated by: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.