Extended Janeway lesions in Enterobacter infective endocarditis: a case report

Area of Science:

• Cardiology
• Infectious Diseases
• Dermatology

Background:

• Infective endocarditis (IE) is a severe heart valve infection with diverse clinical signs.
• The modified Duke criteria aid IE diagnosis, with Janeway lesions being a key indicator.
• Janeway lesions are characteristic skin findings in certain IE cases.

Purpose of the Study:

• To present a case of infective endocarditis diagnosed with the help of Janeway lesions.
• To discuss the diagnostic challenges and management of IE caused by Enterobacter species.
• To underscore the significance of recognizing unusual IE manifestations.

Main Methods:

• A case report of a Middle Eastern male patient in his mid-60s.
• Inclusion of patient history: ischemic heart disease, diabetes mellitus, chronic kidney disease, and hypertension.
• Diagnostic confirmation via skin biopsy revealing Janeway lesions.

Main Results:

• The patient presented with respiratory symptoms and extensive skin lesions.
• Skin biopsy confirmed Janeway lesions, leading to IE diagnosis.
• Infective endocarditis was attributed to Enterobacter species.
• Despite treatment, the patient's condition did not improve.

Conclusions:

• Recognizing atypical IE presentations, like Janeway lesions, is crucial for diagnosis.
• Skin biopsy is a valuable tool for diagnosing IE.
• Effective management strategies are needed for IE caused by uncommon organisms like Enterobacter.