Definition

Lymphangitis in children refers to an infection or inflammation of the lymphatic vessels. These vessels are crucial to the body's immune system, transporting fluid from the lymph glands to the bloodstream. Organs within the lymphatic system include the tonsils or adenoids at the back of the throat, the spleen on the left side of the abdomen, and the thymus gland in the chest cavity.

The lymphatic system is vital in filtering fats, fluids, proteins, and other substances, aiding in the body's defense against foreign bodies and harmful germs. When infections are detected, the body increases white blood cell production to combat them.

Lymphangitis can result from bacterial, viral, or parasitic infections. It often occurs when germs enter the lymphatic vessels through untreated skin wounds. While lymphangitis is more common in adults, children and adolescents can also experience this infection.

Causes

The primary cause of lymphangitis in children is infection with Streptococcus pyogenes, also known as Group A Streptococcus. This bacterium possesses specific properties enabling it to enter the lymphatic vessels. Lymphangitis caused by this bacterium can progress rapidly and carry a risk of severe complications.

Staphylococcus aureus can also cause lymphangitis, although it is more commonly associated with cellulitis resulting from Streptococcus pyogenes infection (Group A Streptococcus).

Other organisms capable of causing lymphangitis include:

• Pseudomonas sp.
• Streptococcus pneumoniae
• Aeromonas hydrophila
• Wuchereria bancrofti

Lymphangitis may also arise from pathogens entering the lymphatic vessels through other infections or wounds in the body. Children who frequently play outdoors barefoot may encounter lymphangitis, as the fungi responsible for the condition can be in the soil.

Risk factor

Some factors that can elevate the risk of a child developing lymphangitis include:

• Diabetes mellitus
• Immunodeficiency (a condition where the body is unable to combat infections)
• Varicella infection (chickenpox)
• Prolonged use of steroids
• HIV infection
• Playing outdoors barefoot

Symptoms

The symptoms of lymphangitis in children can vary from mild to severe. They often present as skin abnormalities, such as redness or swelling and the appearance of red streaks or patches.

Other symptoms may include:

• Fever
• Pain in the affected area
• Swelling of lymph nodes, typically in the groin, armpit, and elbow folds
• Rapid heartbeat (tachycardia)
• Loss of appetite
• Fatigue
• Headaches

Diagnosis

Diagnosing lymphangitis typically involves a medical interview, physical examination, and diagnostic tests. The doctor will inquire about the symptoms, the child's medical history, and any ongoing treatments.

During the physical examination, the doctor will check the neck, armpits, groin, and other body parts for lumps or enlargement of the lymph nodes.

If necessary, the doctor may also conduct diagnostic tests such as blood tests to observe signs of infection, a biopsy to determine the cause of swelling, or a radiological examination for a clearer view of the affected areas.

Management

Treatment of lymphangitis in children needs to be prompt to prevent complications, and medication must be chosen based on the organism causing the infection and the symptoms.

Children with stable conditions, aged over 3 years, without fever, and not experiencing dehydration can be managed with oral antibiotics (if the infection is bacterial). In such cases, children can be treated on an outpatient basis.

The doctor may also recommend other medications, such as:

• Antivirals, if the lymphangitis is caused by a viral infection
• Antifungals, if the lymphangitis is caused by a fungal infection
• Analgesics to relieve pain
• Anti-inflammatory drugs to address inflammation and swelling
• Fever-reducing medication

Warm compresses can also be applied to the affected area to help reduce pain and inflammation. Elevating the infected area and minimizing movement (immobilization) can also reduce the spread of infection, pain, and swelling.

Complications

Untreated lymphangitis can lead to various risks and complications, including:

• Worsening of cellulitis condition
• Death of surrounding infected tissue
• Formation of ulcerative wounds (wounds that extend into the inner skin)
• Bacteremia (presence of bacteria in the bloodstream)
• Sepsis a life-threatening condition in which the body has an excessive response to infection

Prevention

Preventing lymphangitis in children can be challenging as it often arises as a complication of other diseases or from skin wounds. However, maintaining good skin hygiene can help reduce the risk.

To prevent lymphangitis in children, consider the following measures:

• Maintain skin hygiene by regularly using lotion or moisturizer, especially if your child has dry skin.
• Provide protection for your child when they play outdoors, such as wearing appropriate clothing and footwear.
• Promptly treat any wounds your child may have to prevent infection.
• Encourage your child always to wear shoes when engaging in outdoor activities to reduce the risk of injury and infection.
• Advise against swimming if your child has open wounds on the skin to prevent exposure to bacteria in water.
• Keep your home clean to minimize the risk of insect or mosquito bites, which can lead to infections.
• Exercise caution when your child is near animals to prevent potential exposure to harmful bacteria or parasites.

When to see a doctor?

Seek medical advice promptly if your child exhibits symptoms of lymphangitis or if symptoms do not improve after a few days of treatment.

Watch for the following symptoms in children:

• Spreading red rash in the infected area
• Discharge or pus from the infected lymphatic vessels
• High fever (above 38 degrees Celsius)

If your child experiences any of these symptoms, seek medical attention immediately. Prompt and appropriate treatment is necessary to prevent serious complications.

You can also get consultations about lymphangitis in children by downloading the Ai Care app from the Play Store or App Store.

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