What Is the Difference Between Lymphangitis and Lymphadenitis?

Lymphangitis is the inflammation of the lymph vessels or channels through which the lymphatic fluid flows. Lymphangitis is usually caused by a skin injury or abscess. Also referred to as neoplastic lymphangitis, lymphangitis can be caused by malignancies.

The most common causes of lymphangitis are group A beta-hemolytic streptococci and staphylococci. However, in immunocompromised people, lymphangitis can be caused by other microorganisms, such as:

• Gram-negative bacteria, anaerobes
• Bite wounds (Pasteurella multocida)
• Nematodes (filariasis)
• Cancers
  • Breast
  • Prostate
  • Stomach
  • Lung
  • Pancreatic
  • Colorectal

If you already have a skin infection, bacteria can enter your system and inflame the lymph vessels. Bacteria can also enter the body through the rash or blisters of chickenpox. 

Nonbacterial causes of lymphangitis include fungal infections caused by the fungus Sporothrix schenckii as well as spider and insect bites.

If you have a persistent illness that weakens your immune system and reduces your ability to fight infections, you are more likely to develop lymphangitis. You could be more prone to lymphangitis if you have Crohn's disease, an inflammatory condition (such as rheumatoid arthritis), diabetes, or immunodeficiency due to other causes. Another risk factor to consider is being bitten or scratched by a dog or cat.

Lymphadenitis is the inflammation of lymph nodes and is often a side effect of bacterial infections, although it can be caused by viruses or other disease agents. Lymphadenitis can be generalized, encompassing several lymph nodes, or localized, restricted to a few nodes. Lymphadenitis is sometimes associated with lymphangitis.

The most common causes of lymphadenitis are streptococcal and staphylococcal bacteria. However, viruses, protozoa, rickettsia, fungi, and tuberculosis can infect the lymph nodes. Diseases or disorders that involve lymph nodes in specific parts of the body can cause lymphadenitis:

• Tularemia (rabbit fever)
• Cat scratch disease
• Lymphogranuloma venereum
• Chancroid
• Genital herpes
• Infected acne
• Dental abscess
• Bubonic plague 
• Cellulitis (a deep, widespread tissue infection caused by a cut or sore)
• Tonsillitis
• Mononucleosis
• Cytomegalovirus infection
• Toxoplasmosis
• Brucellosis

Symptoms of lymphangitis include:

• Fever and chills
• Muscle aches
• Headache
• Irregular, linear skin erythema or redness
• Swollen and painful lymph nodes
• Loss of appetite
• Headache

Lymphangitis can spread fast, within hours. If you experience any of the associated symptoms, you should contact a doctor right away. If lymphangitis is not treated, it can cause additional problems, such as a skin infection (cellulitis or a pus-filled abscess). 

The most dangerous problem you want to prevent is the infection spreading into your blood circulation and causing sepsis, which can quickly become fatal.

Lymphadenitis begins with swelling of the lymph nodes. A buildup of tissue fluid and an increase in the number of white blood cells occur because of the body's reaction to the infection. Other symptoms may include:

• Fever and chills
• Enlargement of the nodes
• Pain and tender to touch
• Loss of appetite
• Excessive sweating
• Rapid pulse
• Overall weakness or fatigue
• Fluid drain from nodes through the skin
• Skin redness over the nodes

There are various treatment modalities to deal with the infection that causes lymphangitis:

• Antibiotics: Oral or intravenous
• Nonsteroidal anti-inflammatory drugs: Over-the-counter ibuprofen to relieve pain, inflammation, and swelling
• Warm compresses: Can help reduce pain and inflammation
• Surgery: May be needed in serious cases, such as when an abscess forms

Lymphadenitis tends to spread rapidly, and treatment should start right away. Medical attention is needed to rule out the possibility of cancer. Treatment may include:

• Medications: May differ depending on the bacteria or virus that causes the infection
• Assistive care: Cold compresses to alleviate pain and inflammation
• Surgery: Involves draining the pus and antibiotic therapy in the case of an abscess; if lymphadenitis is associated with cellulitis, surgical treatment should be avoided to prevent the spread of the infection
• Biopsy: If no diagnosis has been made and there is no response to therapy, a biopsy of an inflamed lymph node may be done