Nonbacterial Causes of Lymphangitis With Streaking

Brandon E. Cohen, MD; Arielle R. Nagler, MD; Miriam Keltz Pomeranz, MD


J Am Board Fam Med. 2016;29(6):808-812. 

In This Article

Fungal Infections

The lymphocutaneous form of sporotrichosis typically manifests as nodular lymphangitis, characterized by the development of linear, erythematous lesions and subcutaneous nodules.[10–14] However, there have been reports of patients presenting with lymphangitic streaks without nodules.[15,16] In 1 such case, a pediatric patient presented with tender ulcers with raised borders and ascending lymphangitic streaks on the right upper extremity. The patient was treated with antibiotics, and symptoms worsened. Culture revealed infection with Sporothrix schenckii, and the patient was successfully managed on oral itraconazole.[15]

Lymphangitic streaking has also been associated with cutaneous Aspergillus infection. A 40-year-old man with acute lymphoblastic leukemia receiving chemotherapy presented with a tender, edematous fifth toe with lymphangitic streaks along the dorsal foot. Cultures revealed infection with an Aspergillus species without evidence of bacterial infection, and the patient was ultimately managed on amphotericin B and itraconazole.[17]