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Streptococcal/Staphylococcal Adenitis

Acute lymphangitis is an inflammatory process that involves the superficial lymphatic system. It is most often the result of group A streptococci and can result from Staphylococcus aureus or Pasteurella multocida infections. The portal of entry is usually a wound on the extremity, infected blister, or paronychia. Pain along the lymphatics and regional draining lymph nodes is common as, are systemic symptoms.

The diagnosis is suggested by the appearance of red, linear streaks extending from the primary lesion toward the regional lymph nodes, which are enlarged and tender. Rarely, the skin over the primary lesion may break down, forming an ulcer.

Differential Diagnosis: Streptococcal/staphylococcal adenitis can be distinguished from cutaneous anthrax in the following manner.

Streptococcal/Staphylococcal adenitis

 

Cutaneous anthrax

*The primary wound is associated with red, linear streaks toward regional lymph node

 

*Ulcer with eschar is painless

* Ulcer and eschar are surrounded by characteristic non-pitting edema

* Lymphatic vessels are not involved

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