Síndrome linfocutáneo de causa infecciosa: revisión narrativa y enfoque diagnóstico

Introduction: Lymphocutaneous syndrome is a very characteristic clinical form of lymphangitis that presents with subcutaneous inf lammatory nodules that follow a path. Multiple infectious pathologies that could have this clinical presentation have been described and their diagnostic approach is key to successful treatment. Methods: A search was made in PubMed MEDLINE and later a narrative review describing the different infectious etiologies of the lymphocutaneous syndrome. Results: Lymphocutaneous syndrome can have multiple causes, among which are fungal, bacterial, infections by typical or atypical mycobacteria, and parasites, being Sporothrix schenckii, Nocardia brasiliensis, Mycobacterium marinum and Leishmania sp. the most frequently associated agents. To determine its etiology, it is necessary to consider aspects in the anamnesis (origin, occupation, time of evolution, history of trauma), semiology of the lesions, associated symptoms and in many cases diagnostic confirmation with skin biopsies, culture or Gram stain, or other additional studies. Its treatment should be directed and generally due to the involvement of lymphatic pathways, it is extended for a longer time compared to localized infections. Conclusions: when we are faced with a patient with findings suggestive of lymphocutaneous syndrome, we must consider multiple infectious etiologies. In order to make the diagnostic approach easier, we propose to classify the causal agents into 4 main groups: fungal, bacterial, mycobacterial, and parasitic infections.