Recurrent Lymphangitis of the Leg Associated with Dermatophytosis

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THE syndrome of recurrent lymphangitis, often resulting in permanent lymphedema, has been recognized for many years. Ochsner, Longacre, and Murray1 gave a comprehensive discussion of this syndrome in 1940, and yet, even today, the clinical diagnosis of acute lymphangitis is frequently missed. Moreover, the cause of the recurrent attacks of lymphangitis is still not clear. Some authors2,3 believe that recurrence is secondary to foci of infection in the body. Others4 believe that recurrence is due to an acquired hypersensitivity of previously infected tissues. The majority of authors believe that usually there is some portal of entry for bacteria through the skin in order to cause the lymphangitis.

That there is more than a casual relationship between dermatophytosis (athlete’s foot) and the repeated attacks of lymphangitis has been suggested by Allen and Ghormley,5 by Sulzberger, Rostenberg, and Goetze,6 and in several textbooks.7–11 It is the purpose of this paper to discuss 25 consecutive cases of recurrent lymphangitis associated with dermatophytosis treated at the Cleveland Clinic in the years 1950 through 1958, and the clinical course subsequent to treatment.

Clinical Signs and Symptoms

The attacks of lymphangitis are characteristic in the acuteness of their onset and the severity of the systemic reaction. They usually occur suddenly, without warning, and within a few hours the symptoms are extremely severe. Occasionally there is a dull pain in the affected extremity, which rapidly becomes acute. A severe, shaking chill with fever as high as 106 F. usually initiates the attack. Associated symptoms include malaise, anorexia, . . .



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