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LYMPHANGITIS and lymphoedema.pptx
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- 2. DEFINITION •Lymphangitis is an inflammationof the lymphatic channels that occurs as a result of infection.
- 3. ETIOLOGY • Spesies ofgroup A beta hemolytic streptococci • Staphylococcus aureus • Pseudomonas spesies • Wucheria bancrofti
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- 5. PATHOGENESIS • Invasion ofmicroorganisms either from traumatized skin, or from a distal site of infection into the lymphatic vessels that leads to inflammation of the vessel.
- 6. PATHOGENESIS Spesies of groupA beta hemolytic streptococci Staphylococcus aureus Pseudomonas spesies Wucheria bancrofti Invasion microorganism from traumatic skin Enter lymphatic channel Subsequent infection ensuse Manifesting as red streaks on the skin
- 7. CLINICAL SYMPTOMS • Localsymptoms: • Red macular linear streaks from site of infection toward the regional draining lymph node • Tenderness and warmth over affected skin • May have lymph node involvement • May have blistering of affected skin • Systemic symptoms: • Malaise • Fever and chills • Loss of appetite • Headache • Muscle aches
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- 9. DIAGNOSIS • LABORATORY 1. Completeblood count (CBC) may show leukocytosis. Blood cultures • IMAGING 1. Plain radiology unnecessary • DIAGNOSTIC PROCEDUR 1. Aspirate and culture any pus. 2. Use sensitivity to guide antibiotic treatment.
- 10. THERAPHY •Rest and elevationof the affect limb •Symptomatic theraphy •Etiology Specific antibiotic theraphy •Surgical DebridementIncision and drainage abscess areas
- 11. PROGNOSIS • Without appropriateanti microbal theraphy cellulitis may extend along the channel; necrosis and ulceration may occur. • Anti microbal regimens are effective in more than 90% cases • Morbidity and mortality is related to the underlyng infection
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- 14. DEFINITION • Lymphedema isa condition in which protein rich fluid accumulates in the tissues due to a failure of the lymphatic system.
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- 16. RISK FACTOR •Congenital orinherited abnormalities •Trauma,surgery, filariasis •Recurrent skin infection Non cancer •Tumor causing obstruction of lymphatic channels or nodes •Breast cancer •Head and neck surgery •Colorectal cancer Cancer •Radiation theraphy •Lymph node biopsy or dissection Cancer treatment related
- 17. PATHOGENESIS Non cancer Cancer Cancer relatedtreatment Inadequate lymphatic outflow Leads to lymphatic hypertension and decreased contraclity of lymph Lymphostatis, accumulation of lymph, interstisial fluid, protein and glycosaminoglycans Statis of lymph cause accumulation of protein and cellular metabolites in the extracellular space Water accumulation, formation of edema and increased interstitial hydraulic pressure
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- 19. CLINICAL SYMPTOMS •A feelingof heaviness and tightness •Sweilling hands, fingers,arms and legs •Aching or discomfort •Skin hardness and tightness
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- 24. THERAPHY • The mostcommon treatments are a combination of manual compression lymphatic massage, compression garments or bandaging.
- 25. PROGNOSIS • There isno cure for lymphedema, and it is a progressive condition. The outlook will depend to some extent on the severity of symptoms
Editor's Notes
- #11 Antibiotics (1)[A]: Dicloxacillin: Adults: 500 mg p.o. q6h Children: 50 mg/kg/d divided into q.i.d. dosing Nafcillin: Adults: 2 g IV q4h Children: 150 mg/kg/d divided into q.i.d. dosing Cephalexin: Adults: 500 mg p.o. q6h Children: 50 mg/kg/d p.o. divided into q.i.d. dosing Clindamycin (if penicillin or cephalosporin allergy): Adults: 150–300 mg p.o. q6–8h or 600 mg IV q8h Children: 8–20 mg/kg/d p.o. divided into t.i.d. or q.i.d. dosing; 20–40 mg/kg/d IV/IM divided into t.i.d. or q.i.d. dosing Acetaminophen or ibuprofen for pain and fever Second Line Trimethoprim-sulfamethoxazole (TMP-SMZ) good for areas with high rates of methicillin-resistant S. aureus [MRSA]): Adults: 160 mg TMP/800 SMZ mg p.o. q12h × 10–14 days Children >2 months of age: 10–20 mg/kg/d p.o. or IM divided into t.i.d. or q.i.d. doses × 14 days