Concluded Case

LYMPHOEDEMA LOWER LIMB

A 30 years old male with bilateral lymphoedema lower limbs - minimal on right side and more significant on left side . There is no history of travel outside the state - which questions the probability of filariasis. Now there is secondary lymphangitis and sero - sanguinous discharge from the limb Opinions regarding this case are welcomed

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It is a casebof lymphoedema due to lymphatic drainage system may primary or secondary causing disruption of the drainge system either by surgery involvement of lymph node of the draining area or by infection like filariasis or incase filarial obstruction due to presence of death mycobacteria filariae in the lymph channel causing obstruction. Due to stasis of lymph invites infection leading to redness and pain with rise of temperature with chill and rigor and causes sero saguinous discharge. Needs urgent treatment as may lead to septaecimia. Limb elevation Sterile dressing coverage Inj Ceftriaxone 1 gm + Salbactum 500 I'm/ iv bd to continue Anti inflammatory Chymoral forte one tds Analgesic anti pyretic bd or sos Complete remission difficult and it is a recurrent process.

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It is a casebof lymphoedema due to lymphatic drainage system may primary or secondary causing disruption of the drainge system either by surgery involvement of lymph node of the draining area or by infection like filariasis or incase filarial obstruction due to presence of death mycobacteria filariae in the lymph channel causing obstruction. Due to stasis of lymph invites infection leading to redness and pain with rise of temperature with chill and rigor and causes sero saguinous discharge. Needs urgent treatment as may lead to septaecimia. Limb elevation Sterile dressing coverage Inj Ceftriaxone 1 gm + Salbactum 500 I'm/ iv bd to continue Anti inflammatory Chymoral forte one tds Analgesic anti pyretic bd or sos Complete remission difficult and it is a recurrent process.

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Lymphangitis can spread quickly, so typically recommend aggressive treatment of the underlying infection.This person will need hospitalization and antibiotics to treat a bacterial infection. Red and serous sanguious discharge on the skin are a characteristics sign of an infection of the skin or subcutaneous tissues, especially when the infection is spreading from its original site. In this case, other symptoms, such as pain, tenderness, swelling, and warmth typically accompany the red streaks. Sir plan I&D on discharge part, Su-mag dressing,pain killers, Required venous dopplar and routine investigation

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UNILATERAL SWELLING LOWER LEG.. LYMPHOEDEMA .. WITH.. LYMPHANGITIS.. NEED'S CLINICOPATHOLOGICAL EVALUATION WITH.. COLOUR DOPLAR STUDY..AND.. ROUTINE INVESTIGATIONS.. NEED'S.. I&D .. ANTIBIOTICS.. SURGEONS OPINION..

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Lyumphangitis Physical examination with nodes Biopsy HP Blood culture and sensitivity Stapylo streptococcus infection most likely

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Lympoedema with lymphangitis Since it is bilateral need to evaluate some pathology at pelvic area

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Bilateral lymphedema is usually due to obstruction higher up in pelvis. ? Lymphatic obstruction due to enlargement of lymphnodes, thoracic duct obstruction. Long standing lymph stasis will invite bacterial lymphangitis. Look for sources of infection in skin break, intertrigo. Needs Elevation, antibiotics, dressings. hetrazan. Rule out hypoproteinemia, anemia, cirrhosis of liver . gross obesity, Abdominal ultrasound and chest xray After acute phase is overcome, lymphangiogram can be done .

Lymphoedema . Lymphedema in arm or leg can lead to serious complications, such as: Infections. Possible infections that can result from lymphedema include a serious bacterial infection of the skin (cellulitis) and an infection of the lymph vessels (lymphangitis In this case sero sanguineous discharge is caused following infection, an urgent treatment by concerned expert must be initiated in view of probability of septicemia.

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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

Bilateral lymphoedema lower limb ,may be due to filariasis etc cause to be excluded

Postural drainage only ,antibiotics for infection

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