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Difficulty: EasyCardiovascular System

Match each classic peripheral manifestation of infective endocarditis with its correct clinical description.

  • Osler nodesPainful, raised, violaceous nodules usually found on the pads of the fingers and toes
  • Janeway lesionsNontender, erythematous macules typically located on the palms and soles
  • Roth spotsExudative, edematous hemorrhagic lesions of the retina with pale centers
  • Splinter hemorrhagesRed-brown linear streaks occurring under the nail beds

Answer

Osler nodes match with painful, raised nodules on the digit pads. Janeway lesions match with nontender macules on the palms and soles. Roth spots match with retinal hemorrhages with pale centers. Splinter hemorrhages match with linear streaks under the nail beds.
Infective endocarditis presents with characteristic peripheral stigmata due to either microvascular embolization or immunologic phenomena. Osler nodes are painful immune complex deposits on the fingertips and toes. Janeway lesions are painless septic microemboli on the palms and soles. Roth spots are immunologically mediated retinal lesions. Splinter hemorrhages result from capillary microemboli situated longitudinally under the nail beds.

Step-by-Step Solution

1
Differentiate the cutaneous stigmata of infective endocarditis based on the presence of pain.
Osler nodes are identified as the painful lesions, whereas Janeway lesions are identified as the nontender lesions.
Pain is the primary distinguishing clinical feature between Osler nodes (immunologic) and Janeway lesions (embolic).
2
Identify the characteristic ocular finding of infective endocarditis.
Roth spots are identified as the retinal hemorrhages with pale centers.
Ophthalmoscopic examination can reveal these specific immune-mediated vascular lesions in the eye.
3
Identify the classic nail bed abnormality.
Splinter hemorrhages are identified as the linear, red-brown streaks under the nails.
Microemboli to the nail bed capillaries cause these characteristic linear hemorrhages.

Key Concept

Peripheral Stigmata of Infective Endocarditis
Estimated Time:45s
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Topics

Cardiovascular System

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