How inflammation develops
The lymphatic system collects interstitial fluid and returns it to the bloodstream, simultaneously filtering it through the lymph nodes. When bacteria, most often streptococci or staphylococci, enter the skin, they penetrate the lymphatic capillaries. The walls of the blood vessels become inflamed, become permeable, the surrounding tissues swell and turn red - this is how visible stripes appear. The infection moves to regional lymph nodes, which become enlarged and painful. If the protective barrier of the node does not work, microbes enter the blood.
- Entrance gate - wound, scratch, crack
- Most often streptococci and staphylococci
- Inflammation of the wall of a lymphatic vessel
- Red stripes along the vessels
- Enlarged regional lymph nodes
- Risk of infection spreading to the blood
Causes and risk factors
The primary source is most often a small, seemingly insignificant injury: a cut, a splinter, an insect bite, an ingrown nail, a panaritium. A special role is played by fungal infection of the feet with cracks between the toes - this is a classic entry point for erysipelas and lymphangitis of the lower extremities. The risk is higher in people with diabetes, obesity, chronic swelling of the legs after surgery or radiation therapy, varicose veins and reduced immunity.
- Wounds, abrasions, bites, splinters
- Panaritium, boil, abscess
- Foot fungus and interdigital cracks
- Diabetes mellitus
- Chronic lymphostasis and varicose veins
- Immunodeficiency conditions and use of immunosuppressants
Symptoms
A typical sign is narrow, bright red, painful stripes running from the wound to the armpit or groin area. The skin over them is hot and slightly swollen. At the same time, general symptoms increase: fever, chills, headache, weakness, and sometimes nausea. Lymph nodes along the path of spread become enlarged and painful. With deep lymphangitis, there may be no visible stripes, but the limb swells, becomes painful and tense, and the condition worsens quickly.
- Red stripes from the wound to the lymph nodes
- Soreness and heat in the band area
- Enlarged, painful lymph nodes
- Fever and chills
- Edema of the limb
- General weakness and headache
Diagnostics
The diagnosis is usually made during examination: the doctor finds the primary lesion, assesses the extent of redness, and marks its boundaries in order to track its dynamics. A blood test shows an increase in white blood cells and C-reactive protein. A culture is taken from the wound to select an antibiotic. Ultrasound examination of soft tissues helps to identify accumulations of pus that require opening, and duplex scanning of veins helps to exclude thrombophlebitis, which also causes painful redness along the vessel.
- Inspection of the lesion and marking the boundaries of redness
- General blood test
- C-reactive protein, in severe cases procalcitonin
- Culture of wound discharge
- Ultrasound of soft tissues
- Duplex scanning of veins to exclude thrombophlebitis
Treatment and prevention
The basis of treatment is antibiotics, which are prescribed by the doctor, taking into account the likely pathogen and the severity of the condition. At the same time, the primary focus is treated and, if necessary, opened: without this, the inflammation returns. The limbs provide rest and elevation, which reduces swelling and pain. It is impossible to heat or rub the affected area - this contributes to the spread of infection. For prevention, it is important to treat even minor wounds, treat foot fungus, monitor glucose levels in diabetes, and take care of the skin for swelling.
- Antibacterial therapy as prescribed by a doctor
- Treatment and, if necessary, opening of the primary lesion
- Rest and elevated position of the limb
- Painkillers and antipyretics for fever
- Prohibition on heating and rubbing
- Treatment of foot fungus and skin care
- Blood glucose control in diabetes mellitus
