Lymphadenitis "As Rosary beads" - a diagnostic challenge


  • Vitorino Modesto dos Santos Armed Forces Hospital and Catholic University of Brasília
  • Micheline Silva Abreu de Azevedo Hospital of West, Barreiras-BA, Brazil
  • Katia Rejane Marques Brito Hospital of West, Barreiras-BA, Brazil
  • Larissa Almondes da Luz Hospital of West, Barreiras-BA, Brazil
  • Kayursula Dantas Ribeiro Hospital of West, Barreiras-BA, Brazil

Palabras clave:

diagnosis, nodular lymphangitis, sporotrichosis, trauma, ulcer.


Introduction: nodular lymphangitis (NL) may be a manifestation of various infectious and non-infectious conditions, characterised by subcutaneous inflammatory nodules that extend from the site of the primary focus to the regional lymph nodes. NL usually constitutes a challenge in primary health care, and histopathological and microbiological evaluations are necessary to establish the definitive diagnosis. Methods: We report a classic case of NL that developed in the upper limb of a middle-aged man after trauma on the right thumb. The objective:  was to emphasise some aspects of the differential diagnosis in a patient with NL and to reduce the rate of misdiagnosis in the scenery of initial medical attention. Results: the clinical manifestations were non-specific, but the microbiological study revealed typical characteristics of sporotrichosis. The treatment with itraconazole (200 mg daily) for six months was successful. Conclusion: NL constitutes a challenging condition and the early diagnosis depends on a high index of suspicion. Case reports may reduce late diagnoses with unfavourable results.

Biografía del autor/a

Vitorino Modesto dos Santos, Armed Forces Hospital and Catholic University of Brasília

Adjunct-professor, Internal Medicine Department

Micheline Silva Abreu de Azevedo, Hospital of West, Barreiras-BA, Brazil

Medical Doctor, Endocrinology Division

Katia Rejane Marques Brito, Hospital of West, Barreiras-BA, Brazil

Internal Medicine Division

Larissa Almondes da Luz, Hospital of West, Barreiras-BA, Brazil

Internal Medicine Division

Kayursula Dantas Ribeiro, Hospital of West, Barreiras-BA, Brazil

Dermatology Division


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