[Osler's node and Janeway lesion]
Anouk Morier-Genoud1, Laurent Christin2
1Service de médecine, Hôpital de Nyon, 1260 Nyon.
Abstract:
An 82 years old woman is admitted with altered mental state and fever. Initial examination reveals a systolic murmur and purple nodular and maculopapular lesions on her hands and fingertips (figure 1) evocative of Osler's node and Janeway lesions. Though their definition remains unclear, their presence is highly suggestive of endocarditis and is associated with a higher rate of extra-cardiac complications. Positive blood cultures and transthoracic echocardiography confirm the diagnosis. With multi-organ involvement due to septic emboli, the evolution is quickly severe and patient dies during hospital stay.
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