Intended for healthcare professionals

Rapid response to:

Endgames Case Scenario

Creeping lymphangitis

BMJ 2015; 351 doi: (Published 13 October 2015) Cite this as: BMJ 2015;351:h5416

Rapid Response:

Re: Creeping lymphangitis

If infective lymphangitis is strictly defined as a distinct component from infective lymphadenitis, then it may be correct to suggest there is rarity: otherwise, no.

Lymphadenitis complicating infections particularly in the lower limbs is very common and could not be without some element of associated lymphatic inflammation via which the pathogens must need access the lymph glands as an anatomic precondition.

However, such lymphangitic precondition may be subclinical, presenting with none of the dermal changes observed in classical infective lymphangitis, beyond some tenderness in the groin (inguinal adenitis) or similar nodal substations.

It is also relevant to mention that the redness of the lymphangitis may be less typical the darker the natural skin color is and therefore tenderness along suspected lymphatic routes even in absence of clinical erythema should still raise a certain level of suspicion for lymphangitis.

Competing interests: No competing interests

14 October 2015
basil J fadipe
surgeon. clinical prof of surgery and anatomy
justin fadipe centre
mero heights, dominica. west indies