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Jul 24, 2023 · As per the modified Duke criteria, Osler nodes are considered immunologic phenomena of infective endocarditis, and Janeway lesions, vascular phenomena. Osler nodes more commonly correlate with subacute endocarditis, whereas Janeway lesions typically occur in acute infective endocarditis.
- Janeway Lesions: a Painless Manifestation of Infective ...
Janeway lesions and Osler’s nodes are both classic stigmata...
- Janeway lesions: a valuable clinical sign in patients with ...
Janeway lesions: a valuable clinical sign in patients with...
- Janeway Lesions: a Painless Manifestation of Infective ...
- What Are Osler Nodes and Janeway Lesions?
- What Is Bacterial Endocarditis?
- Osler Nodes
- How Did Osler Nodes Get Their Name?
- What Is The Cause of Osler nodes?
- What Tests Should Be done?
- What Is The Treatment of Osler nodes?
- Janeway Lesions
Osler nodes and Janeway lesions are two rare but well-known skin manifestations of bacterial endocarditis. They have also rarely been described in systemic lupus erythematosus (SLE), gonococcaemia (gonorrhoea), haemolytic anaemia and typhoid fever. They are important as they may help in the earlier diagnosis of a serious medical disorder.
Bacterial endocarditis is an infection of the lining of the heart caused by various bacteria. It most often affects the heart valves. The bacteria gain access to the heart via the bloodstream; an infection elsewhere in the body may or may not be apparent. While some bacteria can cause infection in normal heart valves, bacterial endocarditis more co...
Osler nodes are red-purple, slightly raised, tender lumps, often with a pale centre. Pain often precedes the development of the visible lesionby up to 24 hours. They are typically found on the fingers and/or toes. They can occur at any time during the course of endocarditis (usually subacute) and last from hours to several days.
The lesions were first described by French Physicians as ‘Nodosites Cutanees Ephemeres’ meaning ‘Cutaneous nodulesof short duration’ and by Dr Mullen of Hamilton. Parkes Weber later suggested that they are known as Osler nodes in recognition of the fact that Sir William Osler (1849-1919) had "first called attention to their full diagnostic importan...
The underlying cause of the nodes has been debated since Osler first proposed micro-embolisation as a cause (this is the scattering of tiny particles around the bloodstream). Early reports favoured an allergic or immunological cause, but more recent reports have isolated bacteria from within the nodules. A skin biopsy (histology) may reveal a neutr...
A careful search for endocarditis is made. This includes multiple blood cultures, other blood tests, urine tests, ECG, chest X-ray, and an echocardiogram (heart ultrasoundscan). The diagnosis may be elusive. A skin biopsymay be helpful to confirm the diagnosis of the Osler nodes.
Treatment of Osler nodes is aimed at the bacterial endocarditis and involves intravenous antibioticsand sometimes valve surgery. The skin lesions tend to heal spontaneously without scarring.
In contrast to Osler nodes, Janeway lesions are non-tender, often haemorrhagic (bleeding into the skin), and occur mostly on the palms and soles on the thenar and hypothenar eminences (at the base of the thumb and little finger respectively). They tend to last days to weeks before healing totally. Janeway lesions are more commonly seen in acute end...
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Are Janeway's lesions and Osler's nodes a clue to infectious endocarditis?
Are Janeway's lesions a sign of infectious endocarditis?
Was Janeway's erythema a symptom of bacterial endocarditis?
What are Janeway lesions?
Jun 15, 2020 · Janeway lesions, Osler’s nodes and splinter hemorrhages are the classical signs of IE previously described in the literature. It was commonly seen in cases of IE in pre-antibiotic era and its only present in 3–5% of cases at present. 3 Janeway lesions are irregular, non-tender, hemorrhagic macules typically located on the palm and soles of ...
- Seng Wee Cheo, Qin Jian Low
- 2021
Janeway's lesions and Osler's nodes are highly prized clues to the diagnosis of infectious endocarditis that are often searched for but seldom found. Only a relatively few physicians have actually seen an Osler's node, and even fewer can clearly distinguish an Osler's node from a Janeway's lesion.
Janeway lesions are one of the stigmata of infectious endocarditis. They are irregular, erythematous, flat, painless macules on the palms, soles, thenar and hypothenar eminences of the hands, tips of the fingers, and plantar surfaces …
