Nodular lymphangitis: Difference between revisions

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* Characterized by purulent nodules appearing along the course of reqional lymphatics
*Characterized by purulent nodules appearing along the course of reqional lymphatics


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


=== Full list ===
===Full list===

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

Revision as of 12:25, 16 August 2020

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

Differential Diagnosis

Most 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 species 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 species worldwide soil, water, or seage nodules
Herpes simplex virus worldwide 2 to 12 days vesicles
Vaccinia virus cattle and cats

Full 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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