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Pathogenesis of Osler's nodes

J S Alpert, H F Krous, J E Dalen

    Annals of Internal Medicine
    |October 1, 1976
    PubMed

    Insights

    Osler's nodes, skin lesions in endocarditis patients, are likely caused by small blood clots (emboli) carrying bacteria or fungi. Pathogens like Staphylococcus aureus and Candida albicans were identified in these lesions.

    Area of Science:

    • Infectious Diseases
    • Dermatology
    • Pathology

    Background:

    • Endocarditis is a serious infection of the heart lining.
    • Osler's nodes are a clinical manifestation of infective endocarditis.
    • The exact etiology of Osler's nodes has been debated.

    Observation:

    • Pathogenic organisms were isolated from aspirates of Osler's nodes in four autopsy-verified endocarditis cases.
    • Staphylococcus aureus was identified in three cases, and Candida albicans in one.
    • Histologic examination revealed microabscesses and microemboli in Osler's nodes.

    Findings:

    • Microemboli within Osler's nodes support their embolic origin.
    • The findings align with Osler's original hypothesis.
    • This challenges previous interpretations of perivasculitis due to immunologic reactions.

    Implications:

    • Confirms the embolic nature of Osler's nodes.
    • Enhances understanding of infective endocarditis manifestations.
    • Provides diagnostic value for identifying causative agents in Osler's nodes.

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