Recurrent Osler's Nodes in Systemic Lupus Erythematosus

RuDusky, Basil M.

doi:10.1177/000331976902000105

Cited by 7 publications

(2 citation statements)

References 10 publications

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“…Although classically seen in IE, Osler's nodes and Janeway lesions have been observed in other disease processes. A broad differential diagnosis for the lesions includes systemic lupus erythematosus, 19 infected arterial line, 20 cutaneous vasculitis, meningococcemia, gonococcemia, disseminated intravascular coagulation, thrombocytopenia, enterovirus infections, Rocky Mountain spotted fever, and cholesterol embolization 8…”

Section: Janeway Lesionsmentioning

confidence: 99%

Getting to the Heart of the Matter

Bernstein

Leasure

Buel

2007

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A 60-year-old woman returned from visiting a cousin in Texas. For the past 6 weeks, she had not been feeling well and had lost almost 30 lb. She had frequent night sweats, although she did not recall having taken her temperature. Upon evaluation in the emergency department, results of physical examination were notable for cachexia and poor dentition. She was noted to have pyuria, and therapy was initiated for a urinary tract infection. Results of blood cultures performed the same day were positive for gram-positive cocci, and vancomycin therapy was initiated. She developed difficulty in seeing to her, left and a computed tomographic scan of the brain was performed; results were interpreted as negative. A transesophageal echocardiogram showed a 3-cm mass attached the posterior leaflet of the mitral valve. Initial interpretation was of an atrial myxoma. One of the authors was asked to consult on the case and noted bilateral conjunctival hemorrhages (Figure 1). Subsequently, the blood culture isolate was identified as Streptococcus mitis. Magnetic resonance imaging confirmed multiple cerebral infarcts consistent with embolic origin. The patient underwent emergent cardiac surgery, and her mitral valve was replaced with a bioprosthetic valve. She successfully completed a 4-week course of antibiotic therapy for her endocarditis.

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Section: Janeway Lesionsmentioning

confidence: 99%

Getting to the Heart of the Matter

Bernstein

Leasure

Buel

2007

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“…(4) se siguen considerando que los nodulos de Osler, las manchas de Roth y la glomerulonefritis secundaria a EI están mediadas inmunológicamente. Los nódulos de Osler son lesiones cutáneas no patognomónicas de endocarditis y se han descrito también en la fiebre tifoidea, lupus eritematosos sistémico, gonococemia y endocarditis trombótica no bacteriana (9,19), pero son lesiones que deben hacer sospechar al clínico la presencia de una EI. Así, se han descritos casos en los que los nódulos de Osler han sido el signo físico que ha dirigido el diagnóstico hacia una endocarditis (20,21), en alguna ocasión por microorganismos que no crecen en los hemocultivos como Chlamydia pneumoniae (22).…”

Section: Tabla Iunclassified

Utilidad diagnóstica de los nódulos de Osler en la endocarditis infecciosa en usuarios de drogas por vía parenteral (UDVP)

Parra

Rincón

Huerta

et al. 2002

An. Med. Interna (Madrid)

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Las manifestaciones cutáneas de la endocarditis infecciosa incluyen petequias, hemorragias subungueales, nódulos de Osler y lesiones de Janeway (1). Los nódulos de Osler son lesiones cutáneas nodulares eritematosas dolorosas, localizadas preferentemente en el pulpejo de los dedos. La naturaleza histológica de estas lesiones es dudosa (2,3). Clásicamente se consideraban lesiones vasculíticas mediadas inmunológicamente sin formación de microabscesos,concepto que se sigue empleando en los libros de texto (1) y en los nuevos criterios diagnósticos de endocarditis de Durack y cols. (4). En la literatura más reciente se recoge que las biopsias de los nódulos de Osler se observan datos histológicos de microembolismos con cultivo positivo de las mismas (2,3). El objetivo de este trabajo es describir los datos clínicos, microbiológicos e 39 [0212-7199(2002) 19: 6; pp 299-301] ANALES DE MEDICINA INTERNA

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