home Audience 6 Retrograde lymphangitis. Lead to the development of lymphangitis. In case of severe intoxication of the body,

Retrograde lymphangitis. Lead to the development of lymphangitis. In case of severe intoxication of the body,

Lymphangitis - inflammation lymph capillaries and trunks, which occurs against the background of purulent-inflammatory processes.

Lymphangitis is accompanied by painful swelling, redness along the inflamed lymphatic vessels, regional lymphadenitis, edema, fever up to 39-40°C, weakness, chills.

Causes

Lymphangitis develops secondarily, that is, as a result of an existing deep or superficial purulent-inflammatory focus (infected abrasions, wounds, furuncle, abscess, carbuncle, phlegmon). The causative agents of lymphangitis are beta-hemolytic streptococcus, Staphylococcus aureus, coli, proteus, other aerobic microflora. Specific lymphangitis is more often associated with the presence of tuberculosis in a patient.

The probability of developing the disease depends on the location, size of the primary infectious focus, the characteristics of the lymph circulation in this anatomical zone, and the virulence of the microflora.

Microbial agents, as well as their toxins from the focus of inflammation enter the interstitial space, then into the lymphatic capillaries, lymph nodes.

Symptoms of lymphangitis

With lymphangitis, intoxication of the body is largely expressed, which is accompanied by high fever (39-40 ° C), chills, weakness, sweating, and headache.

Reticular lymphangitis usually begins with the appearance of severe redness around the site of infection (abscess, wound, etc.) with an enhanced mesh pattern.

Stem lymphangitis is characterized by the presence of red narrow stripes on the skin along the inflamed lymphatic vessels that stretch to the regional lymph nodes. Compaction, swelling, soreness of cords, tension of surrounding tissues, swelling, regional lymphadenitis develop rapidly. Palpation (palpation) along the vessels reveals painful seals like a rosary or cord.

With deep lymphangitis, there is no local redness, but swelling and pain in the limb quickly increase. With deep palpation, a sharp soreness is revealed, lymphedema (lymphedema) develops quite early.

In the case of perilymphangitis, the area of inflamed surrounding tissues can transform into a subfascial phlegmon and abscess, the untimely opening of which is fraught with the occurrence of sepsis.

Symptoms of chronic lymphangitis are erased, usually characterized by persistent edema as a result of blockage of deep lymphatic trunks and impaired lymph outflow.

Diagnostics

Reticular lymphangitis can be diagnosed during a visual examination. In establishing the diagnosis, it is necessary to identify the primary inflammatory focus.

Deep lymphangitis is more difficult to diagnose. In this case, clinical and anamnestic data are taken into account, as well as the results of instrumental, laboratory research. There is significant leukocytosis in the peripheral blood. Ultrasound dopplerography and duplex scanning reveal changes in the lymphatic vessels (heterogeneity of the structure, narrowing of the lumen, the presence of a hyperechoic rim around the vessels, reactive changes in the respective lymph nodes).

Assessment of the severity, depth and prevalence of lymphangitis is carried out using computer thermography.

Determination of the pathogen is carried out by the method bacteriological culture detachable wound.

With complicated lymphangitis, a blood test for sterility is performed.

Types of disease

By clinical course distinguish between acute and chronic lymphangitis.

Taking into account the severity and nature of inflammation, lymphangitis can be simple (serous) and purulent.

According to the depth of the location of the affected lymphatic vessels, lymphangitis can be superficial or deep.

Depending on the caliber of the inflamed vessels, capillary (reticular, reticular) and truncular (stem) lymphangitis are distinguished. With reticular lymphangitis, many superficial lymphatic capillaries are involved in the inflammatory process, and with stem lymphangitis, several or one large vessel is inflamed.

Patient's actions

If symptoms of lymphangitis occur, it is necessary to consult a surgeon. With lymphangitis, self-heating of the site of inflammation, massage, rubbing ointments are unacceptable.

Treatment of lymphangitis

It is necessary to eliminate the primary focus, which supports inflammation in the lymphatic vessels. For this purpose, infected wounds are treated, abscesses, phlegmons, panaritiums are opened, they are drained and sanitized. The affected limb is fixed in an elevated position. The patient is advised to rest.

Medical therapy includes application antibacterial agents(semi-synthetic penicillins, 1-2 generation cephalosporins, aminoglycosides, lincosamides), anti-inflammatory and antihistamines, conducting infusion therapy, ultraviolet and laser blood irradiation.

In chronic sluggish lymphangitis, local ointment dressings, half-alcohol compresses or compresses with dimethyl sulfoxide, UVI, mud therapy are prescribed.

Complications

long chronic course diseases can lead to a disorder of lymphatic circulation, obliteration of the lymphatic vessels, the development of lymphostasis, elephantiasis.

Prevention of lymphangitis

Prevention of lymphangitis includes timely primary surgical treatment of wounds, sanitation of pustular diseases, opening of formed purulent foci, adequate antibiotic therapy.

Lymphangitis is an inflammation that is located in the lymphatic trunks and capillaries and is acute or chronic flow and occurs due to the presence of purulent exudate. In the presence of this pathology, lymphatic vessels of various diameters and locations are affected.

Lymphologists and phlebologists in most cases deal with the pathology of the limbs. This is due to their excessive trauma, the presence of a sufficient number of pathogenic m/organisms and the nature of the process of lymph circulation. The course of the disease is most often accompanied by manifestations of secondary lymphadenitis. If a patient begins to develop lymphagitis, then with highly likely there is a process of progression of the underlying disease and its course is aggravated.

The main reasons for the development this disease- abscesses, wounds and other inflammatory processes in which the causative agents are:

staphylococcal infection;
streptococcus beta-hemolytic;
various aerobic pathogens, which include Escherichia coli.

If a person has a history of tuberculosis, a specific lymphangitis develops.

There are a combination of certain factors that provoke the appearance of pathology. These include:

the location and size of the initial focus of infection;
virulence of microflora;
feature of the lymph flow in this area.

From the site of the development of the inflammatory process, microbes and the toxins that they secrete are sent to the space between the tissues, and then move through the lymphatic capillaries with the movement of the lymph to large vessels and nodes.

A fairly rapid spread of inflammation is manifested in the following manifestations:

the epithelium swells;
increased permeability of the vascular wall;
exudative process develops;
fibrin clots fall out;
blood clots form in the middle of the vessel.

All this contributes to the violation of lymph circulation and the formation of lymphostasis. Further progression of the disease leads to the development of lymphangitis with purulent contents.

During the spread of inflammation on the tissues, perilymphangitis is formed, which provokes vascular damage, muscle tissue and joints. Thanks to ascending path lymph flow pathology expands its boundaries and reaches the lymphatic duct, which is located in the chest.

Doctors note that more often it is necessary to diagnose lymphangitis of the legs, which develops due to attrition, injury, scratching, the presence of a trophic ulcer or panaritium.

It is worth noting that doctors report a condition called "non-venereal penile lymphangitis." It is formed due to trauma to the tissues of the organ during masturbation and sexual intercourse, which are of a protracted nature. There is also a specific lymphangitis, which develops when exposed to sexually transmitted diseases. It is formed due to the presence of such diseases in a man:

syphilis primary;
herpes genital;
urethritis, which is caused by a sexual infection.

Kinds

Depending on the different characteristics disease, it can take the following forms:

serous;
purulent;
acute;
chronic.

By the depth at which the pathological vessels are located, it is possible to identify a superficial or deep disease.

The diameter of the lymphatic vessels affected by inflammation can be different. According to this characteristic, lymphangitis is divided into the following types:

capillary;
stem.

In the presence of reticular lymphangitis, the inflammatory process covers a large number of capillaries located in the upper layers, and in the presence of stem inflammation affects only a few vessels of large diameter (or even one).

Symptoms

During the course of lymphangitis, patients note general intoxication, which accompanies inflammation, heavy with purulent contents. At the same time, the temperature rises to 40 degrees, the person feels chills, sweats a lot, weakens, and his head hurts a lot.

The onset of reticular lymphangitis is accompanied by the formation of hyperemia of a pronounced nature, which is observed around the infected area. Also here the mesh pattern intensifies against the background of erythema, which at this time is already very intense.

The clinical picture of mesh lymphangitis is very similar to erysipelas, but the borders of hyperemia are clear.

With stem lymphangitis, narrow red stripes appear, the location of which is located in the region of the lymph nodes damaged by the inflammatory process. At the same time, swelling appears, the tissue becomes denser, painful cords, edema appear, the surrounding tissues tighten - regional lymphadenitis is formed. Feeling the vessels helps to identify the seal, which hurts and resembles a cord or a rosary.

Deep lymphangitis is not accompanied by hyperemia, but swelling and pain in the leg increases with high speed. On palpation, pain is noted, and lymphedema begins to develop quite early.

With perilymphangitis, abscesses or subfascial phlegmon may form in areas of inflamed tissues, which, if untimely opened, can lead to sepsis.

Symptoms of chronic lymphangitis are not pronounced. With this pathology, persistent edema appears due to blockage of the lymphatic vessels and the development of lymphostasis.

In the presence of non-venereal lymphangitis, a dense cord is formed on the penis along the coronary sulcus, which is not painful and can last up to several days, and then disappears on its own.

Diagnostics

A lymphologist can easily determine reticular lymphangitis even during examination. He is also obliged to differentiate it from erysipelas and phlebitis. This helps to determine the initial focus of inflammation.

Diagnosis of deep lymphangitis is often quite difficult. Here it is important to collect an anamnesis, to conduct all necessary research and process the results.
If a leukocytosis is found in the peripheral blood, which is pronounced, then lymphangitis can be suspected.

When conducting ultrasound and duplex scanning, the heterogeneous structure of the lymphatic vessel, a decrease in its diameter, a hyperechoic rim, as well as ongoing changes in the nearby lymph nodes are visible.
Computed tomography helps to assess the severity of the process, how widespread it is and how deep it is.

The results of a comprehensive study help to distinguish between deep-lying lymphangitis from thrombophlebitis occurring in deep veins, osteomyelitis or purulent inflammation soft tissues.
With a bacteriological study, it is possible to determine the pathogen that stimulates the development of lymphangitis, and the complicated course of the pathology requires a study of blood for sterility.

Treatment

Initially, it is necessary to identify and eliminate the root cause of the pathology, which provokes the inflammatory process in the vessel through which the lymph flows. To do this, it is necessary to treat the wound, open suppuration, drain and sanitize. The leg should be fixed in a slightly elevated position, the patient should be advised to calm down and lie down without much movement.

It is forbidden to use massage as a therapy in case of illness, warm up the inflamed areas or rub any kind of medicines.

With this pathology, the following drugs are used:

drugs of the antibiotic group penicillin series, aminoglycosides, cephalosporins and lincosamides;
non-steroidal anti-inflammatory e (ibuprofen, nimesulide, diclofenac);
antiallergic (loratadine, desloratadine, cetrin and others).

Also treated with intravenous administration drugs, blood irradiation with ultraviolet or laser.

During the course of the disease chronic form with dimly severe symptoms you can apply bandages with ointment or compresses using alcohol and water at a concentration of 1: 1 or dimexide. You can treat with special mud, and if inflammation develops stubbornly, the doctor prescribes X-ray therapy.

Non-venereal lymphangitis of the penis does not need treatment, and if other causes of the disease are found, the underlying infection should be treated.

The inflammatory process, sometimes accompanied by the formation of pus, in the small blood vessels and lymph nodes on the penis is called lymphangitis. This disease is non-infectious, therefore it is not transmitted sexually. What is lymphangitis of the penis, its causes and symptoms, as well as the basic principles of treatment, we will consider in more detail.

The main causes of the development of the disease

It is impossible to identify the exact cause of the inflammatory processes. Factors that lead to the appearance lymphangitis on the penis, are:

sexual intercourse in an uncomfortable position;
too frequent masturbation;
painful stimulation of the penis;
mechanical trauma to the penis;
experiments in bed in the form of non-standard poses;
damage to the penis during sexual contact or self-gratification;
disorderly sex life With frequent change partners

essence lymphangitis of the penis consists in excessive friction of the head during intercourse or masturbation. As a result, the young man feels severe itching and burning. Over time, this condition leads to inflammation of the lymph nodes on the genitals.

Symptoms of pathology

This disease does not have a venereal nature, so a man cannot infect his partner. Define lymphangitis on the penis possible if the following symptoms occur:

too frequent urination;
the genitals look inflamed;
man is experiencing pain during intimacy;
lymph nodes in the area of the head of the penis increase;
redness of the penis as a result of damage to the blood vessels.

What does it look like lymphangitis of the penis, can be seen on photo.

When pathogenic microorganisms purulent discharge begins to be observed at the site of inflammation. Such an inflammatory process can worsen the condition. The following symptoms are added:

increase in body temperature;
fever;
severe headaches;
general weakness of the body;
fast fatigue.

In addition to the physical deterioration of well-being, there may also be psychological disorders. A man becomes irritable, confused, aggressive, there is a tendency to depression.

What does purulent look like lymphangitis of the penis, can be seen on photo.

Non-venereal coronal lymphangitis

Non-venereal coronal lymphangitis of the penis- a fairly common form of the disease. It can be observed no more than a few days. The main reasons for the development of this form of pathology are:

trauma to the penis;
prolonged and private sexual contact or masturbation.

Main Feature non-venereal lymphangitis of the penis This form is that the symptoms characteristic of this disease disappear on their own without treatment after a few days. In most cases, coronal lymphangitis is sluggish in nature, and therefore does not require a serious approach to treatment.

Diagnosis of the disease

To establish accurate diagnosis with lymphangitis on the penis, a visual examination is necessary. The doctor assesses the condition skin and mucous membranes of the penis, the severity of edema, the presence of a rash, the condition of blood vessels and lymph nodes. For appointment necessary treatment The patient is referred for the following laboratory tests:

general blood analysis;
a smear for microflora from the urethra;
PCR diagnostics.

Non-venereal lymphangitis of the penis requires the exclusion of diseases such as syphilis, herpes, bacterial urethritis And so on.

Basic principles of treatment

This pathology provides for treatment at home, if it is not accompanied by purulent secretions. Usually after 3-4 days lymphangitis on the penis disappears on its own. In a complicated form accompanied by pus, the following medications are prescribed:

Antibiotics. They aim to eliminate pathogens, inflammatory processes and pain. For these purposes, such antibacterial drugs: Ampicillin, Clarithromycin, Cefatoxime and others.
Probiotics. They are aimed at preventing dysbacteriosis during the use of antibiotics. The most common probiotics are: Bifiform, Linex, Bifidumbacterin.
Non-steroidal anti-inflammatory drugs. This group of medicines helps to eliminate inflammatory processes, thereby alleviating the condition. For this, such means are used: Ibuprofen, Ibufen, Indomethacin and others.
Antihistamines. They must be taken to eliminate symptoms such as swelling of the penis, redness. They also help improve the functioning of blood vessels. Examples of such drugs: Suprastin, Loratadin, Diazolin.

Combine treatment medications follows with physiotherapy procedures.

Treatment with folk remedies

Drug therapy can be supplemented with the use of alternative medicine. Consider the most effective recipes:

Nettle, hop cones, oregano, yarrow. All components must be taken in equal proportions. 3 art. l. mixture should be poured with 0.5 liters of boiling water. Insist for half an hour. Drink 1 glass of ready-made infusion 3 times a day.
Mint. You will need peppermint leaves crushed to the consistency of gruel. Put a small amount on a piece of bandage, apply to the inflamed area. Keep the compress for about 20 minutes.
Soda. Treatment of lymphangitis of the penis with soda provides for rinsing with a solution. To do this, dissolve 1 tsp. soda in 1 glass warm water. Wash the body 2 times a day.

Treatment prognosis lymphangitis of the penis almost always positive. But then you have to follow preventive measures in order to avoid its re-development.

which may arise from different reasons. Its appearance is accompanied by a number of characteristic symptoms.

No one is immune from this disease, and therefore now it will be told about why it can arise, by what signs it can really be determined, and also how diagnosis is carried out and treatment is carried out.

The manifestation of the disease

To begin with, it is worth talking a little more in detail about what lymphangitis is. Is it chronic or acute inflammation lymphatic capillaries or trunks, which occurs secondarily. It is always preceded by a purulent-inflammatory process.

Accompanied this phenomenon swelling along the inflamed vessels, which is visible to the naked eye. Edema is also possible. Often formed and lymphadenitis - inflammation of the lymph nodes of a purulent nature.

It is important to note that with this disease, completely different vessels located at any depth can be affected. As a rule, inflammation is concentrated on the limbs, and this is logical - after all, they are most often injured.

You need to consult a doctor, barely noticing the weak manifestations of lymphangitis, the photo of which shows a truly unpleasant sight. If a person has begun to progress this disease, it means that the primary pathology is progressing.

Etiology

Many people know that the lymphatic system is a complex vascular structure. When pathogenic bacteria and viruses enter the body, immune cells are produced in the lymph, which become an obstacle for them, and also purify the blood.

If this protection is not present (the reason is severe infection and weakened immunity), then this “barrier” does not arise.

As a result, bacteria from the purulent focus enter the interstitial space. And from there to lymphatic system. As a result, the endothelium small vessels damaged and inflammation occurs. First, mesh lymphangitis is formed, and then - stem.

Causes

As mentioned earlier, lymphangitis (ICD-10 - I89.1) develops a second time. A prerequisite is a deep or superficial purulent-inflammatory focus. In general, the reasons can be listed as follows:

Infected wound or abrasion.
Phlegmon.
Carbuncle.
Abscess.
Furuncle.

If we talk about pathogens, then they are the following pathogens:

Staphylococcus aureus.
Proteus.
Beta-hemolytic streptococcus.
Escherichia coli.

It is important to make a reservation that specific lymphangitis usually occurs in patients who have had tuberculosis.

Symptoms

There are several signs by which you can determine the presence of lymphangitis. The symptoms are as follows:

Heat reaching 39-40 °С.
Severe superficial hyperemia observed around the infectious focus.
The presence of narrow stripes of red color on the skin that stretch to
Soreness, induration, swelling of the bands.
Tension and swelling of the surrounding tissues.
Painful seals along the course of the vessels, resembling a rosary or cords.
Chills.
strong headache.
Weakness.
Sweating.

Over time, the symptoms get worse. There is a sharp pain, lymphedema begins to develop, some areas are transformed into an abscess or phlegmon. If they are not opened, sepsis may develop.

Diagnostics

Lymphangitis lower extremities or any other parts of the body can be determined by a specialist during a visual examination. The difficulty lies in only one thing - the disease must be differentiated from superficial phlebitis and erysipelas. And here the identification of the inflammatory focus helps.

It will be difficult to identify deep lymphangitis. What it is? This is the name of an ailment in which pronounced leukocytosis can be detected in the peripheral blood. That is why it is necessary to take this biological fluid for analysis.

In addition, the lymphologist must take into account the results of laboratory and instrumental research and clinical and anamnestic data.

The patient is also referred for the following diagnostic procedures:

duplex scanning.
UZDG.
Computer thermography.
Bacterial seeding.

All this helps to determine changes in the lymphatic vessels, narrowing of the lumen, the depth and severity of lymphangitis, and also determine which microorganism was the causative agent.

Principles of treatment

So, based on the foregoing, you can understand what lymphangitis is. This serious illness, and with its treatment it is better not to delay.

The first step is to eliminate the primary focus, which supports inflammation in the lymphatic vessels. To do this, the doctor processes and opens phlegmon, panaritiums, abscesses, after which he drains and sanitizes them.

Then the affected limb is fixed in a slightly elevated position. A person will have to observe motor rest.

Many people do not immediately go to the doctor, and prefer to treat themselves. So, you can't do this! Still strictly prohibited before opening (and after) the following actions:

Rubbing ointments.
Warming up the affected area.
Massage.

Drug treatment is indicated, but only a lymphologist prescribes it, and only after the patient has been examined.

Medical therapy

Now you can talk about the treatment of lymphangitis. After the above steps have been completed, the rehabilitation period, during which a person must drink a course of drugs. He may be assigned:

Cephalosporins: Cefazolin or Cefotaxime. They have a bactericidal effect.
Macrolides: "Erythromycin" or "Azithromycin". They have a bacteriostatic effect.
Aminoglycosides: "Gentamicin" or "Netilmicin". Effective in treating infections.
Antihistamines: "Suprastin" or "Tavegil". Suppresses the action of free histamine.
Anti-inflammatory nonsteroidal drugs: "Nimesil" or "Ibuprofen". Well relieve redness of the skin, swelling, pain and inflammation.

Chronic and persistent course

These are special cases. To cure a patient who is faced with a chronic or persistent course of lymphangitis of the extremities (or other part of the body), appoint:

Local ointment bandages.
Mud treatment.
Compresses with dimethyl sulfoxide or the addition of alcohol.
X-ray therapy.

Also special occasion is venereal infectious lymphangitis. This Hard case, but the treatment here is simple - it is directed to the elimination of STDs.

What drugs will be prescribed by a venereologist depends on the pathogen. In the fight against gonorrhea, some medicines help, for the treatment of syphilis, other medicines will be required - everything is very individual.

Non-venereal lymphangitis of the penis

This ailment deserves separate consideration. With it, usually, the vessels around the coronal sulcus or along the trunk of the organ are affected. Most men who have experienced this problem had:

Frequent and prolonged intimate acts.
Unusual postures, due to which the penis was bent.
Increased masturbation.

TO specific symptoms manifestations include:

Sharp pain in inguinal region.
Discharges of a purulent nature.
Swelling and induration of the penis.
The appearance of painful and purulent infiltrates.
General intoxication.

Non-venereal lymphangitis of the penis is treated in the same ways as inflammation that has arisen in another part of the body. However, in this case there are specific recommendations.

So that inflammation does not occur in such intimate place, you need to avoid any injury to the penis and long masturbations. It is necessary to adhere to a measured sex life, as well as to observe hygiene.

Lymphangitis of the lungs

A specific inflammation that can become cancerous. With this disease, metastases spread through the lymphatic vessels of the lungs. In these cases, the primary cancer occurs in the pancreas, breast, colon, or stomach.

The following symptoms are observed:

Often a person is unsuccessfully treated for tonsillitis and bronchitis, as the symptoms are similar. But here it is necessary to carry out x-ray examination. It is this that allows you to notice the transformation of the lung pattern, as well as other changes.

X-rays must be booked immediately. It is better to make a mistake in the assumptions than to allow the lymph nodes to enlarge to such a size that they begin to appear on the tomogram.

Folk remedies

They can be used during the rehabilitation period only after the permission of the doctor. The following are popular:

Freshly squeezed beetroot juice mixed with carrot in a ratio of 1:4. This drink is a natural "supplier" of chlorine to the body, which is necessary for the activity of the lymph nodes.
Baths made from dried walnut leaves. You need to take them in an amount of 1 kg, pour water (2-3 l) and boil for 45 minutes. For a foot or sitz bath, ¼ of this volume is sufficient. In the usual will have to pour the entire broth.
Nettle decoction. This plant has an excellent anti-inflammatory effect. You need to take 1 tbsp. l. nettle leaves and brew 1 cup boiling water. Let it brew for 30 minutes. Strain and drink half a glass twice a day before meals.
Dandelion decoction. This plant is a storehouse of vitamin C and the antioxidant luteolin. You need to take 1 tsp. dandelion leaves, pour a glass of boiling water and leave for 20 minutes. Then strain. Drink ¼ half an hour before meals three times a day.
Aloe tincture. This plant is used to treat various severe ailments, even pneumonia and radiation sickness. You need to rinse a few leaves of aloe and squeeze out the juice - you should get 150 ml. Then mix with 1 glass of honey, dilute with Cahors (350 ml). Infuse the mixture for 5 days in a dark place. Then take 1 tbsp. l. three times a day half an hour before meals.

These are good remedies, and with their help you can strengthen the immune system, but they are not a substitute for drug treatment. We must remember this.

Complications

If a person does not ignore the symptoms, starts treatment on time, then the disease can be eliminated without consequences. Otherwise, he will suffer from complications, including:

Circulatory disorder.
Lymphedema.
Infection of the lymphatic vessels.

And these complications, in turn, are fraught with serious consequences. Lifedemus, for example, is almost always eliminated surgically- cross the vessels with subsequent coagulation of the central ends and the creation of anastomoses.

A circulatory disorder is completely fraught with the release of blood outside the vessels and a change in its volume.

That is why it is important to immediately seek help from a doctor. Once launched, an untreated infection can lead to very serious consequences that are dangerous to health and life.

Prevention

Well, about this in the end. Main preventive measure- this is a timely visit to the doctor in the event of suppuration of soft tissues, as well as bringing the treatment infectious disease to end. Don't quit therapy just because it's "already better".

Also, it is impossible to create additional obstacles for lymph drainage. Crossing your legs while sitting, for example, or carrying a heavy bag on your arm.

It is also necessary to observe hygiene, dress warmly and avoid stress. And, of course, it is advisable to regularly undergo a general examination.

It is better to identify the disease on early stage than to treat running stage. This always brings a considerable amount of trouble, takes a huge amount of time, nerves and money.

Lymphangitis (lymphangitis, lymphangitis) - acute or chronic inflammation lymphatic vessels caused pathogenic microflora. The pathological process can affect the vessels different localization, depth and caliber, but in clinical practice more common is lymphangitis of the extremities, which is associated with the peculiarities of lymph circulation, as well as their more frequent injury.

Source: gidmed.com

Causes and risk factors

The causative agents of lymphangitis are staphylococci, β-hemolytic streptococcus, E. coli, Proteus and others aerobic bacteria or their associations. The infection penetrates into the lymphatic vessels from the primary focus ( infected wound, abrasion, abscess, furuncle, carbuncle or phlegmon).

Lymphedema is a pronounced swelling of the affected limb, due to blockage of a large lymphatic vessel and a violation of the outflow of lymph.

The likelihood of developing inflammation of the lymphatic vessels depends on the size and location of the primary focus of infection, the characteristics of the lymph flow in this area of the body, and the virulence of the pathogen.

Infectious agents cause damage to the wall of the lymphatic vessel, which leads to an increase in its permeability, leakage of lymph into the interstitial space, endothelial edema and the formation of intravascular thrombi. The described changes cause lymphostasis, i.e., stagnation of the lymph. At further progression infectious process purulent fusion of the thrombus and the walls of the lymphatic vessel occurs - purulent lymphangitis develops.

In the absence of the necessary treatment, the infection spreads to the tissues surrounding the affected lymphatic vessel (muscles, joints, blood vessels), which indicates the development of perilymphangitis.

In severe lymphangitis, the infection may ascend and spread up to the thoracic lymphatic duct.

If a patient has tuberculosis, a specific tuberculous lymphangitis may form. Sexually transmitted infections (urethritis, genital herpes, primary syphilis) cause specific venereal lymphangitis.

In the practice of urologists, there is lymphangitis of the penis, caused by trauma to the penis during prolonged intercourse or intense masturbation. Other name given state- non-venereal lymphangitis.

Forms of the disease

According to the features of the clinical course, lymphangitis is divided into:

spicy- usually occurs near a superficially located focus purulent infection, pathological changes with it rapidly progressing;
chronic- takes a long time; there is a blockage of deeply located lymphatic vessels, which leads to severe swelling of the extremities.

Against the background of a long course of chronic lymphangitis, gradual obliteration of the affected lymphatic vessels occurs with the development of lymphostasis, and later elephantiasis.

Depending on the existing pathomorphological changes, there are:

serous lymphangitis- there is impregnation of soft tissues along the affected lymphatic vessel with serous inflammatory exudate;
purulent lymphangitis- there is a purulent fusion of the walls of the affected lymphatic vessel, as well as the formation of phlegmon, abscesses along its course;
mesh lymphangitis- observed with damage to small lymphatic vessels and is characterized by pronounced hyperemia of the skin in the form of thin strips extending from the focus of inflammation to the nearest lymph nodes.

Depending on the caliber of the affected vessels, lymphangitis is isolated:

capillary (reticular, reticular)- many superficially located lymphatic capillaries are inflamed;
truncular (stem)- 1-2 large stem lymphatic vessels are affected.

Depending on the depth of the inflamed vessels:

superficial lymphangitis;
deep.

Symptoms of lymphangitis

Acute lymphangitis is always accompanied by a pronounced intoxication syndrome. Its symptoms:

severe weakness;
fever up to 39-40 ° C, accompanied by severe chills;
lack of appetite.

With capillary lymphangitis around the focus of the primary infection (wound, trophic ulcer, abscess), there is a pronounced hyperemia of the skin with an enhanced marble (mesh) pattern. According to the clinical course, the process resembles erysipelas, however, the focus of hyperemia has blurred boundaries, which is not typical for erysipelas.

good healing effect have ultraviolet (UVBI) and laser (ILBI) blood irradiation.

A local manifestation of stem lymphangitis is the appearance on the skin of a bright red strand stretching from the focus of purulent inflammation along the course of the lymphatic vessel to the nearest lymph nodes. The cord quickly becomes painful and indurated, surrounding it soft tissues swell. When carrying out its palpation, a symptom of a rosary is determined (the presence painful seals). Patients develop and rapidly progress to regional lymphadenitis.

With deep lymphangitis, local hyperemia is not observed. There is pain in the affected limb, which sharply increases with movement or deep palpation. Lymphedema develops - a pronounced swelling of the affected limb, due to blockage of a large lymphatic vessel and a violation of the outflow of lymph.

The clinical picture of chronic lymphangitis is erased. Edema of the extremity associated with impaired lymph circulation and lymphostasis is characteristic.

With non-venereal lymphangitis of the penis, a compacted painless cord appears along its coronal sulcus or trunk. It persists from several hours to several days, and then disappears on its own.

Diagnostics

Superficial lymphangitis usually does not cause diagnostic difficulties. However, in some cases the disease requires differential diagnosis with thrombophlebitis of superficial veins and erysipelas. Identification of the primary inflammatory focus helps to make the correct diagnosis.

Some more difficult diagnosis deep lymphangitis. In this case, it is necessary to take into account the data of the anamnesis and clinical symptoms, results of laboratory and instrumental studies. The survey plan includes:

general blood analysis- leukocytosis with a shift is detected leukocyte formula left;
bacteriological examination of the discharge festering wound - allows you to identify the causative agent of the disease, as well as determine its sensitivity to antibiotics;
Ultrasound of the lymphatic vessels- the narrowing of the lumen, heterogeneity of the structure, the presence of a hyperechoic rim around the affected vessel, reactive changes in the regional lymph nodes are determined;
computer thermography- makes it possible to assess the depth and prevalence pathological process, its expression.

A local manifestation of stem lymphangitis is the appearance of a bright red cord on the skin, stretching from the focus of purulent inflammation along the lymphatic vessel to the nearest lymph nodes.

If complications of purulent lymphangitis occur, a blood test for sterility is indicated.

Treatment of lymphangitis

In acute lymphangitis, treatment is aimed at eliminating the primary infectious focus (opening panaritiums, abscesses, phlegmon, followed by drainage purulent cavity, debridement wounds). The patient is shown bed rest. The affected limb is fixed in an elevated position, which helps to improve the outflow of lymph. In the diet, limit the content table salt(no more than 6 g per day). Massage, thermal treatments and active rubbing of ointments is unacceptable.

Drug therapy for acute lymphangitis includes the appointment of antibiotics (lincosamides, aminoglycosides, cephalosporins, semi-synthetic penicillins), antihistamines and anti-inflammatory drugs. To combat intoxication, infusion therapy. Ultraviolet (UVBI) and laser (ILBI) blood irradiation have a good therapeutic effect.

With a specific venereal lymphangitis caused by a sexually transmitted disease, it is treated with antibacterial therapy.

In chronic sluggish lymphangitis, patients are prescribed compresses with dimethyl sulfoxide or half-alcohol, ointment dressings, ultraviolet irradiation of the affected limb, mud therapy. In cases where the disease is persistent, consider the appropriateness of x-ray therapy.

Non-venereal lymphangitis does not require treatment.

Possible consequences and complications

With purulent lymphangitis and the spread of infection to the surrounding soft tissues, their purulent fusion may develop with the formation of abscesses and phlegmon. Untimely autopsy purulent formations may lead to sepsis.

In clinical practice, lymphangitis of the extremities is more common, which is associated with the peculiarities of the lymph circulation, as well as their more frequent injury.

Against the background of a long course of chronic lymphangitis, gradual obliteration of the affected lymphatic vessels occurs with the development of lymphostasis, and later elephantiasis.

Forecast

In most cases, with timely and adequate treatment the prognosis is favorable.

Prevention

Prevention of lymphangitis is based on the following activities:

timely surgical treatment of deep wounds;
adequate antibiotic therapy of infectious and inflammatory diseases;
sanitation of foci of purulent infection.

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