J Manipulative Physiol Ther. 2001 Sep; 24(7): 474-6.

Acute lymphangitis mimicking mechanical neck pain.

Boudreau LA, Pinto A.

Clinical Sciences Resident, Department of Graduate Studies and Research, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada.

OBJECTIVE: To discuss acute lymphangitis as a potentially serious infection that can mimic mechanical musculoskeletal pain. CLINICAL FEATURES: A 27-year-old male plant worker had right-sided neck pain. Numerous lesions on the patient's scalp were observed, but were not considered to be related to the chief complaint. INTERVENTION AND OUTCOME: Conservative therapy was initiated to address what was thought to be mechanical neck pain. Shortly after the initial visit, it became evident that the source of the neck pain was infection because lymphangitis developed. Antibiotic therapy was initiated and complete resolution of the complaint occurred within 1 week. CONCLUSION: Primary contact practitioners should consider all aspects of the patient history and physical findings when formulating a diagnosis. This is especially important in the case of patients presenting with lymphangitis because mismanagement could have serious consequences. The importance of a good patient history and team approach to care is demonstrated by this case.