Osler node, Janeway lesions, and splinter hemorrhages

Fanning, W. Lee; Aronson, Michael P.

doi:10.1001/archderm.113.5.648

Cited by 11 publications

(3 citation statements)

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“…39 Emboli and direct invasion of blood vessels present as generalized maculopapular lesions, which evolve rapidly, or as widespread purpuric lesions. Septic embolization can cause Osler's node, Janeway lesions, [40][41][42][43] petechiae, and splinter hemorrhages. 44 We found that the most frequent cutaneous signs were purpuric nonblanching lesions and petechiae.…”

Section: Discussionmentioning

confidence: 99%

Acute bacterial septic vasculopathy

et al. 2012

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Nine of 32 patients were immunosuppressed. The foci of sepsis were variable; in 17 patients, the focus was not identified. Although Neisseria meningitidis was the most common causal agent, several microorganisms were identified. Cutaneous manifestations were an early event in 90.6% of patients. The most common skin signs were purpuric lesions and petechiae. Overall mortality was 28.1%; 65.5% of patients survived without sequelae. Skin biopsies showed thrombi in 100% of cases. Other common findings were inflammatory infiltrate, blood extravasation, and epidermal involvement. Bacteria within the vascular wall were seen in 21.9% of cases and fibrinoid necrosis in 25%. A comparison of ISPs with NISPs disclosed that meningococcemia was more common in the latter group, and the presence of pustules was more common in the former. Histopathology testing revealed that fibrinoid necrosis and bacterial invasion of the vessel wall were more common in ISPs than in NISPs. Conclusions Several microorganisms can cause septic vasculopathy. Clinical presentation is variable and does not depend on the microorganism or the pathogenic mechanism. Histopathologically, septic vasculopathy is a thrombo-occlusive vasculopathy with variable morphology. Cutaneous lesions are an early event and allow for rapid diagnosis.

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Section: Discussionmentioning

confidence: 99%

Acute bacterial septic vasculopathy

et al. 2012

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“…A retrospective chart review of over 12 500 patients undergoing radial artery catheterization revealed only six cases of pseudoaneurysm formation (an incidence of 0.048%) [2]. The occurrence of an infected radial artery pseudoaneurysm after arterial catheterization is very rare, with only 21 previous reports in the English-language literature over the last 50 years [2,[5][6][7][8][9][10][11][12][13][14]. Only one report of a haemophiliac patient developing a pseudoaneurysm of the radial artery could be found on searching, and this was not infected [15].…”

Section: Discussionmentioning

confidence: 99%

Radial artery mycotic pseudoaneurysm in a haemophiliac: a potentially fatal complication of arterial catheterization

Harkin¹,

Connolly²,

Chandrasekar³

et al. 2002

Haemophilia

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“…Osler nodules are red-purple, painful nodules often with a pale center and usually located on fingers and toes. [6][7][8] They have been reported to be associated with subacute/chronic forms of embolic diseases, most commonly bacterial endocarditis. 9 Janeway lesions, first described by Janeway more than 100 years ago have been associated with acute bacterial endocarditis.…”

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Janeway lesions with inconspicuous histological features

2009

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Septic-embolic diseases are life threatening; survival critically depends on rapid diagnosis. Clinically, cutaneous manifestations like Janeway lesions are infrequently occurring but highly characteristic. In contrast, histological features are not clearly defined. We report the case of a 59-year-old male patient in deteriorating general condition and fever of unknown origin with lesions suggestive for Janeway lesions. Histology showed dilated blood vessels and extravasated erythrocytes throughout the dermis. Only serial sections revealed single, deep dermal vessels occluded by fibrin thrombi. Computed tomography scan identified multiple pulmonary round masses. Blood cultures showed growth of Staphylococcus aureus and Enterococcus faecalis. The knowledge of the described subtle histological features and a clinical-pathological correlation is essential for the diagnosis of certain cases of septic-embolic conditions.

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Osler node, Janeway lesions, and splinter hemorrhages

Cited by 11 publications

References 0 publications

Acute bacterial septic vasculopathy

Acute bacterial septic vasculopathy

Radial artery mycotic pseudoaneurysm in a haemophiliac: a potentially fatal complication of arterial catheterization

Janeway lesions with inconspicuous histological features

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