Nodular lymphangitis: Difference between revisions

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*Characterized by purulent nodules appearing along the course of regional lymphatics
= Nodular lymphangitis =


== Differential Diagnosis ==
==Differential Diagnosis==
===Common===
{| class="wikitable"
!Organism
!Distribution
!Exposures
!Incubation
!Initial presentation
|-
|[[Sporothrix schenckii]]
|South and Central America and southern North America
|gardening (especially roses), other soil contact, animal scratches or bites
|1 week to 3 months
|painless ulcerated nodule
|-
|[[Mycobacterium marinum]]
|worldwide
|fish and aquariums, including salt- and freshwater exposures
|1 to 6 weeks
|mildly tender, ulcerated nodule
|-
|[[Nocardia brasiliensis]]
|worldwide
|soil, cat scratch
|3 days to 6 weeks
|tender, ulcerated, draining nodules
|-
|[[Leishmania brasiliensis]]
|South and Central America
|sand flies
|2 to 24 weeks
|painless, punched-out shallow ulcer
|-
|[[Francisella tularensis]]
|North America
|wild animal exposures (especially hunting) or ticks
|1 to 6 days
|painful ulcerated draining papule
|-
|[[Bacillus anthracis]]
|worldwide
|animal, animal product, or contaminated soil exposures
|
|painless ulcer with vesicles and edema
|-
|[[Staphylococcus aureus]]
|worldwide
|
|4 to 10 days
|abscesses, with or without drainage
|-
|[[Coccidioides immitis]]
|Southwest US and northern Mexico
|soil exposure or laboratory exposure
|1 to 4 weeks
|verrucous plaques and ulcerated nodules
|-
|[[Blastomyces dermatitidis]]
|worldwide, particularly North America
|soil, animal bites or scratches, laboratory exposure
|1 to 5 weeks
|verrucous plaques and ulcerated nodules
|-
|[[Histoplasma capsulatum]]
|worldwide
|soil, birds, laboratory exposure
|5 to 18 days
|myriad
|-
|[[Scedosporium]]
|worldwide
|soil, water, or sewage
|
|nodules
|-
|[[Herpes simplex virus]]
|worldwide
|
|2 to 12 days
|vesicles
|-
|[[Vaccinia virus]]
|
|cattle and cats
|
|
|}


===Exhaustive List===
* Sporotrochosis

* Norcardia
*'''Fungi'''
* Mycobacterium marinarum
**[[Sporothrix schenckii]]: gardening or dirt exposure
* Leishmania
**[[Blastomyces dermatitidis]]
* Francisella
**[[Coccidioides immitis]]
**[[Histoplasma capsulatum]]
**[[Cryptococcus neoformans]]
**[[Scedosporium apiospermum]]
**[[Fusarium]]
**[[Scopulariopsis blochii]]
**[[Eumycotic mycetoma]]
**[[Rhinocladiella aquaspersa]] ([[chromoblastomycosis]])
*'''Bacteria'''
**[[Norcardia]] species, including [[N. brasiliensis]], [[N. asteroides]], [[N. otidiscaviarum]], and [[N. transcalensis]]: soil or water exposure
**[[Mycobacterium tuberculosis]] (tuberculosis cutis verrucosa)
**[[Non-tuberculous mycobacteria]]
***''[[Mycobacterium marinum]]'': saltwater or marine exposure
***''[[Mycobacterium chelonei]]''
***''[[Mycobacterium fortuitum]]''
***Rarely ''[[Mycobacterium kansasii]]''
**''[[Francisella tularensis]]'' (ulceroglandular tularemia): excrutiatingly painful; hunting; deer flies and ticks
**[[Burkholderia pseudomallei]] (melioidosis)
**[[Staphylococcus aureus]]
**[[Streptococcus pyogenes]]
**[[Bacillus anthracis]] (cutaneous anthrax)
**[[Erysipelothrix rhusiopathiae]]
*'''Viruses'''
**[[Vaccinia virus]]
**[[Herpes simplex virus]]
*'''Parasites'''
**[[Leishmania]]
*'''Non-infectious causes'''
**[[Squamous cell carcinoma]]
**[[Basal cell carcinoma]]
**[[Mycosis fungoides]]
**[[Psoriasis]]
**[[Lupus vulgaris]]
**[[Pyoderma gangrenosum]]

==Further Reading==

*Nodular Lymphangitis (Sporotrichoid Lymphocutaneous Infections). Clues to Differential Diagnosis. ''J Fungi''. 2018;4(56). doi: [https://doi.org/10.3390/jof4020056 10.3390/jof4020056]

[[Category:Skin and soft tissue infections]]

Latest revision as of 20:14, 21 April 2025

  • Characterized by purulent nodules appearing along the course of regional lymphatics

Differential Diagnosis

Common

Organism Distribution Exposures Incubation Initial presentation
Sporothrix schenckii South and Central America and southern North America gardening (especially roses), other soil contact, animal scratches or bites 1 week to 3 months painless ulcerated nodule
Mycobacterium marinum worldwide fish and aquariums, including salt- and freshwater exposures 1 to 6 weeks mildly tender, ulcerated nodule
Nocardia brasiliensis worldwide soil, cat scratch 3 days to 6 weeks tender, ulcerated, draining nodules
Leishmania brasiliensis South and Central America sand flies 2 to 24 weeks painless, punched-out shallow ulcer
Francisella tularensis North America wild animal exposures (especially hunting) or ticks 1 to 6 days painful ulcerated draining papule
Bacillus anthracis worldwide animal, animal product, or contaminated soil exposures painless ulcer with vesicles and edema
Staphylococcus aureus worldwide 4 to 10 days abscesses, with or without drainage
Coccidioides immitis Southwest US and northern Mexico soil exposure or laboratory exposure 1 to 4 weeks verrucous plaques and ulcerated nodules
Blastomyces dermatitidis worldwide, particularly North America soil, animal bites or scratches, laboratory exposure 1 to 5 weeks verrucous plaques and ulcerated nodules
Histoplasma capsulatum worldwide soil, birds, laboratory exposure 5 to 18 days myriad
Scedosporium worldwide soil, water, or sewage nodules
Herpes simplex virus worldwide 2 to 12 days vesicles
Vaccinia virus cattle and cats

Exhaustive List

Further Reading

  • Nodular Lymphangitis (Sporotrichoid Lymphocutaneous Infections). Clues to Differential Diagnosis. J Fungi. 2018;4(56). doi: 10.3390/jof4020056
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