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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The peripheral manifestations of bacterial endocarditis are manifold and provide diagnostic clues as to the onset, etiology and potential complications of the disease. Petechiae, splinter hemorrhages, and Osler's nodes are among the more common cutaneous signs of endocarditis thought to be secondary to an allergic vasculitis or, as in the case of Osler's nodes, peripheral emboli. An asymmetric livedo reticularis rash was the initial presentation in a patient we recently treated with peptostreptococcus intermedius endocarditis, a heretofore undescribed dermal sign of endocarditis. Immunofluorescence studies of skin biopsies suggest that a livedo reticular rash may be one of the immune complex vasculitic syndromes associated with endocarditis.
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PMID:Case report: livedo reticularis in endocarditis. 731 65

The pathogenesis of Osler's nodes and Janeway lesions remains a mystery despite vigorous debate over the last 113 years. They are given great emphasis among the clinical signs of bacterial endocarditis but are seldom seen in practice. Two cases of subacute bacterial endocarditis are presented. A 66-year-old woman with Bartonella henselae endocarditis developed Osler's nodes on the hands postoperatively, and a 23-year-old man with Streptococcus oralis endocarditis developed tender macules with an appearance suggestive of Janeway lesions on one heel. The dermatopathology was similar in the two cases, consisting of a leukocytoclastic vasculitis without micro-abscess formation or visible organisms. Although the appearance is usually consistent, it is not always possible to distinguish Osler's nodes from Janeway lesions based purely on clinical presentation. Furthermore, the histology of both clinical signs can look similar. Further reports are needed before more firm conclusions can be drawn, however, it may be that the histological appearance of Osler's nodes and Janeway lesions is primarily determined by the nature of the causative organism, while the clinical appearance may be determined by anatomical site.
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PMID:Osler's nodes and Janeway lesions. 1795 87

In his landmark "Gulstonian Lectures on Malignant Endocarditis," published in 1885, William Osler commented, "Few diseases present greater difficulties in the way of diagnosis than malignant endocarditis, difficulties which in many cases are practically insurmountable." At that time, the fields of microbiology and blood cultures were in their infancy, and the diagnosis was made premortem in just half the patients with the condition. After Osler's report, extracardiac physical findings became essential clues to earlier diagnosis. Today, infective endocarditis is most commonly suggested from the history and often clinched by an echocardiogram and blood cultures. Although prized physical manifestations are much less frequent now, they still do occur and may be an invaluable clue that leads to earlier, more effective treatment. The investigators review these extracardiac findings along with their historical descriptions: splinter hemorrhages, emboli, Osler's nodes, Janeway and Bowman lesions of the eye, Roth spots, petechiae, and clubbing.
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PMID:Extracardiac manifestations of infective endocarditis and their historical descriptions. 1808 31

Despite advances in diagnosis and treatment, infective endocarditis still shows considerable morbidity and mortality rates. The dermatological examination in patients with suspected infective endocarditis may prove very useful, as it might reveal suggestive abnormalities of this disease, such as Osler's nodes and Janeway lesions. Osler's nodes are painful, purple nodular lesions, usually found on the tips of fingers and toes. Janeway lesions, in turn, are painless erythematous macules that usually affect palms and soles. We report a case of infective endocarditis and highlight the importance of skin examination as a very important element in the presumptive diagnosis of infective endocarditis.
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PMID:Dermatologic manifestations of infective endocarditis. 2830 Sep 7

Infective endocarditis (IE) is defined as infection of the endocardial surface of the heart which may involve heart valve, mural endocardium or septal defect. It's a disease with high morbidity and mortality without prompt treatment with antibiotics. Janeway lesions, Osler's node and splinter hemorrhages are the classical signs of infective endocarditis described previously. However, these signs are not commonly seen nowadays. In this present paper, we would like to illustrate a case of IE with typical Janeway lesions.
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PMID:Janeway lesion and Infective Endocarditis. 3253 38


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