Lymphocutaneous Syndrome A Review of Non-Sporothrix Causes

Smego, Raymond A.; Castiglia, Mary; Asperilla, Marianito O.

doi:10.1097/00005792-199901000-00004

Cited by 74 publications

(27 citation statements)

References 203 publications

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“…Increased biological inflammatory parameters are classically noted. In our cases, good general condition, absence of lymph node enlargement, inefficacy of antibiotics (1 case) or rapid spontaneous regression and normal biological inflammatory parameters did not suggest a bacterial etiology of the lymphangitis [1]. …”

Section: Discussionmentioning

confidence: 97%

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Superficial Lymphangitis after Arthropod Bite: A Distinctive but Underrecognized Entity?

et al. 2008

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Background: Acute bacterial lymphangitis is a common occurrence after skin damage. This diagnosis is often made in case of red linear streaks after arthropod bites, leading to the prescription of oral antibiotics. In this setting, noninfectious superficial lymphangitis after arthropod bites, an eruption rarely mentioned in the medical literature, appears as a diagnostic challenge. Objective: Our purpose was to study the clinical and histopathological features of this underrecognized condition. Methods: We collected the observations of six consecutive patients seen between the years 2003 and 2006, who developed an acute linear erythematous eruption along lymphatic vessels, mimicking common bacterial lymphangitis. Standard histological examinations were completed by immunopathological staining using the monoclonal antibody D2-40, a highly selective marker of lymphatic endothelium. Extensive review of the literature about acute noninfectious superficial lymphangitis was performed. Results: The clinical presentation and histological findings excluded an infectious etiology and suggested superficial lymphangitis after an arthropod bite in all the observations. Conclusions: This article analyzes the clinical and histological features of noninfectious superficial lymphangitis after arthropod bite, a benign underrecognized condition mimicking common bacterial lymphangitis. Physicians should be aware of this benign reaction to avoid the useless prescription of antibiotics.

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Section: Discussionmentioning

confidence: 97%

“…Acute lymphangitis is mainly caused by streptococcal infection after skin damage [1, 2]. Other bacterial, parasitic or viral organisms have been identified but noninfectious causes are poorly documented.…”

Section: Introductionmentioning

confidence: 99%

Superficial Lymphangitis after Arthropod Bite: A Distinctive but Underrecognized Entity?

et al. 2008

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“…6 Lymphocutaneous nocardiosis consists of an acute primary cellulitis with lymphangitic spread and causes lymphadenitis. 7,8 Medical treatment of cutaneous nocardia infections is largely empiric and based on experience with treatment of invasive disease. Historically, oral TMP-SMX has been used for treatment of nocardiosis, with minocycline as an alternative.…”

Section: Discussionmentioning

confidence: 99%

Primary Cutaneous Nocardiosis in a Heart Transplant Patient: A Case Report

Devaraj¹,

Rodriguez²,

Hess³

et al. 2010

TMF

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A 38-year-old female with history of longstanding non-ischemic cardiomyopathy underwent orthotopic heart transplantation (OHT). Her past medical history was significant for factor V leiden and methylenetetrahydrofolate reductase (MTHFR) heterozygous deficiencies with chronic pulmonary embolism, sickle cell trait, atrial flutter, type 2 diabetes mellitus, and hypertension. The patient had a long and complicated course post-transplantation. Immediately after OHT, she was noted to have donor-specific human leukocyte antigen (HLA) antibodies treated with 5 cycles of plasmapheresis. On further biopsies it was noted that she had acute cellular rejection requiring pulse-dose parenteral steroids on multiple occasions. Her immunosuppression therapy consisted of tacrolimus, mycophenolate and prednisone. Six months post-transplant she was noted to have a spontaneous 4cm right calf muscle hematoma based on lower extremity ultrasound that was felt to be due to her underlying hematologic disease. At 7 months post-transplant the patient was hospitalized twice. The first admission was for multifocal necrotizing pneumonia. Although sputum cultures were non-diagnostic, the patient improved with 2 weeks of antibiotic treatment. The second admission occurred after a routine right heart catheterization that showed hemodynamic parameters concerning for rejection. At that time, the patient received empiric parenteral pulse steroids while waiting for final pathology results; these were negative for rejection and the patient's immunosupressants were continued at previous doses.The newest hospitalization was 8 months post-transplant, when she was admitted with a chief complaint of worsened right-sided calf pain for a month. On physical exam the patient was noticed to have an area of warmth, induration and palpable tenderness. Patient denied any other symptoms, and specifically denied fevers, chills, respiratory symptoms or trauma. Imaging studies on admission included a lower extremity ultrasound that showed the hematoma had increased in size to 9 cm from previous study 2 months prior. Lab studies to assess any acute hematologic cause of recurrent spontaneous hematoma were negative. The differential diagnosis on admission included a leg abscess; however the absence of fever, leukocytosis and loculations made it seem unlikely. A calf MRI performed 4 days later showed the collection had increased to 13 cm. It was complex but still compatible with hematoma, although superimposed infection could not be ruled out. At this point it was decided for the patient to undergo an ultrasound guided fluid aspiration for diagnostic and therapeutic purpose, given the patient's continuing pain and rate of growth. Fluid aspiration yielded 50 cc of pus. Broad spectrum antibiotics were started, and that evening the patient went to the operating room for an incision and drainage. The following day the wound culture grew a modified acid fast gram positive bacilli (by modified Kinyoun method) that immediately raised the concern for infection with nocardia speci...

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“…The differential diagnosis for this form of sporotrichosis includes infection with M. marinum or another atypical mycobacterium, Leishmania species, and Nocardia brasiliensis [30]. Rarely, other bacterial, fungal, and even viral infections cause a similar lymphocutaneous syndrome.…”

Section: Lymphocutaneous Sporotrichosismentioning

confidence: 99%

Sporotrichosis

Kauffman¹

2015

Diagnosis and Treatment of Fungal Infections

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Lymphocutaneous Syndrome A Review of Non-Sporothrix Causes

Cited by 74 publications

References 203 publications

Superficial Lymphangitis after Arthropod Bite: A Distinctive but Underrecognized Entity?

Superficial Lymphangitis after Arthropod Bite: A Distinctive but Underrecognized Entity?

Primary Cutaneous Nocardiosis in a Heart Transplant Patient: A Case Report

Sporotrichosis

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