A 38 year female presented with an uncertain history of insect bite while sleeping followed by pain and swelling over the left side of her chin. She reported no systemic symptoms.
On examination she was afebrile, a distinct erythematous lesion was seen on her mentum with a serpiginous red streaks extending from the bite site to the submental region with few subcentimeter tender level Ia lymphadenitis.(Figure 1) A provisional diagnosis of post insect bite lymphangitis was made and the patient started on oral co-amoxiclav with complete resolution of the lesion in 48 hours of starting treatment.
A large volume study has revealed that cutaneous suppuration accounts for around 12% of admissions in the United states.1 However lymphangitis in the head and neck region has not been covered well in literature. Marque et al. (2008) has reported that post insect bite lymphangitis which mimics bacterial lymphangitis however it lacks other features of bacterial infection.2
We present to you a clinical image of a common cutaneous bacterial infection which has rarely been reported in the craniofacial region.