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Osler's nodes and Janeway lesions
Todd H Gunson1, G Fergus Oliver
1Department of Dermatology, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand. toddg@adhb.govt.nz
The Australasian Journal of Dermatology
|October 25, 2007
Summary
Osler's nodes and Janeway lesions in bacterial endocarditis present similarly histologically, suggesting organism type influences pathology and site influences clinical appearance. Further research is needed to confirm these findings in bacterial endocarditis.
Area of Science:
- Infectious Diseases
- Dermatology
- Pathology
Background:
- Osler's nodes and Janeway lesions are clinical signs of bacterial endocarditis.
- Their exact pathogenesis remains unclear despite extensive research.
- These signs are emphasized in clinical diagnosis but rarely observed.
Observation:
- Two cases of subacute bacterial endocarditis are presented.
- A 66-year-old woman with Bartonella henselae endocarditis developed Osler's nodes.
- A 23-year-old man with Streptococcus oralis endocarditis developed Janeway lesions.
Findings:
- Dermatopathology in both cases revealed leukocytoclastic vasculitis without micro-abscesses or visible organisms.
- Clinical distinction between Osler's nodes and Janeway lesions can be challenging.
- Histology of both lesions can appear similar.
Implications:
- The histological appearance may depend on the causative organism.
- Clinical presentation might be influenced by the anatomical site of the lesion.
- Further case reports are necessary to solidify conclusions on Osler's nodes and Janeway lesions.
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