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| | Postgraduate Medicine: Compiling the identifying features of bacterial endocarditis |
 | | Lesions that are not affected by turbulent or high-velocity blood flow are less likely to develop into endocarditis. | | | Infectious endocarditis and sudden unexpected death: incidence and morphology of lesions in intravenous addicts and non-drug abusers. | | | The technique allows visualization of vegetation, abscesses, and cardiac lesions and may be helpful in identifying the specific valve that is infected. |
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http://www.postgradmed.com/issues/2000/01_00/harris.htm
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| | Liver Lesions -- Recommendations and Resources |
| | Olney's Lesions have not yet been proven to exist in human subjects. | | | Most are benign but are sometimes removed if they are painful, unsightly or restrict movement. | | | Studies conducted by J.W. Olney -- specifically, on ''animals'' -- evidence the post-dissociative development of tiny holes (dubbed Olney's Lesions) primarily in the posterior cingulate cortex and retrosplenial cortex areas of the brain. |
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http://www.becomingapediatrician.com/health/87/liver-lesions.html
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| | eMedicine - Dermatologic Manifestations of Cardiac Disease : Article by Vibhuti N Singh, MD, MPH, FACC, FSCAI |
| | The lipid compositions of 8 normolipidemic xanthelasma palpebrarum lesions were analyzed in a recent study using thin-layer chromatography, with the adjacent uninvolved skin used as a control. | | | This is in contrast to the erythematous or violet-colored lesions due to localized vasodilatation; they do blanch with pressure. | | | Purpura is seen when an extravasation of RBCs into the dermis occurs, and, as a result, the lesions do not blanch with pressure. |
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http://www.emedicine.com/derm/topic548.htm
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| | CPC: Case Study |
| | None of these lesions commonly extends into the chest wall, or is particularly common in children. | | | A primary chest wall neoplasm (such as a sarcoma) is not consistent with the radiographic findings of a pulmonary infiltrate adjacent to the chest wall mass. | | | The presence of a heart murmur, along with poor dentition, suggests that the process might be endocarditis with septic embolization and chest wall abscess. |
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http://oac.med.jhmi.edu/cpc/cases/2003/cpc5_answer.html
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| | Schamberg's Disease and Other Nonpalpable Purpuras - New Treatments, October 2, 2005 |
| | Infective endocarditis is associated with petechial and purpuric skin lesions. | | | The skin lesions of disseminated gonococcemia begin as tiny red papules and petechiae and then evolve into painful purpuric pustules and vesicles scattered on the distal extremities. | | | The most distinctive hemorrhagic skin lesions are stellate (star-shaped) purpuric ecchymoses with necrotic centers. |
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http://www.ccspublishing.com/journals3a/schambers_disease.htm
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| | White : Diseases of the Skin - Vasculitis and Related Disorders - SMALL-VESSEL LEUKOCYTOCLASTIC VASCULITIS |
| | Systemic corticosteroids are useful for arthralgia if sufficiently severe, and variably useful for renal or skin lesions; for cutaneous disease, this approach is usually reserved for more active or ulcerated lesions. | | | The skin lesions in most of these are similar. | | | These are punched out and painful, without venous stasis changes, and therefore have the clinical appearance of arterial ulceration (see also Chapter 12). |
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http://www.merckmedicus.com/ppdocs/us/hcp/content/white/chapters/white-ch-011-s005.htm
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| | Coda |
| | Also, when Janeway was being choked by the Vidiian in her mind, the actor visibly kept his hands too loosely pressed to her throat (no muscle tension). | | | Janeway then begins to have a series of death experiences, usually returning to the moment before the trouble began. | | | Anyway, I noticed in the beginning of the episode that when Chakotay was performing CPR on Janeway her cheeks puffed out as he was pushing on her chest. |
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http://www.nitcentral.com/voyager/coda.htm
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| | Cecil Textbook of Medicine : /> |
| | Petechiae are most often found on the conjunctiva, palate, and the extremities; like the other peripheral stigmata of IE, they are a nonspecific but suggestive finding (Fig. | | | A widened pulse pressure should alert the clinician to the possibility of acute aortic insufficiency. | | | The skin should be carefully examined for embolic phenomena such as petechiae, Osler's nodes, Janeway's lesions, and splinter hemorrhages. |
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http://www.merckmedicus.com/ppdocs/us/common/cecils/chapters/310_007.htm
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| | The Johns Hopkins AIDS Service: Case Rounds |
| | It most commonly affects the lungs, but it can cause uveitis and skin lesions which are erythematous and plaque-like with central clearing. | | | The "copper penny" lesions on the palms and soles in this case represent the specific physical exam finding that pointed to syphilis. | | | None of the medications prescribed in this case are associated with uveitis. |
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http://www.hopkins-aids.edu/educational/caserounds/caserounds_3.html
(1293 words)
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| | History - Chest Pain |
| | More specifically, do you note clubbing, Janeway lesions or Osler’s nodules (bacterial endocarditis), chest wall deformities such as pectum carniatum (associated with asthma), or trauma (remember to consider the possibility of child abuse). | | | Look for symptoms of respiratory distress, including hyperventilation, which could be the cause of the chest pain. | | | Palpate for tracheal deviation (associated with pneumothorax or atelectasis due to pneumonia). |
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http://www.learnpediatrics.com/respiration/histChest.htm
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| | janeway lesions Resources |
| | MedlinePlus Medical Encyclopedia: Janeway lesion on the finger | | | Study finds laser therapy, ointment effective for vitiligo | | | Janeway lesions are seen in people with acute.. |
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http://www.dermatologyneworleans.com/dermatologist/janeway-lesions.html
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| | THE MERCK MANUAL OF GERIATRICS, Ch. 90, Infective Endocarditis |
| | About 30% of elderly patients with endocarditis have rheumatic lesions, about 25% have calcified valves, and about 5% have mitral valve prolapse; however, about 40% have unidentified or no valvular lesions. | | | Roth's spots (pale-centered oval hemorrhages in the retina) suggest infective endocarditis but also occur in patients with collagen vascular disease or hematologic disorders. | | | The second condition is bacteremia, which results in colonization of the lesion. |
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http://www.merck.com/pubs/mm_geriatrics/sec11/ch90.htm
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| | Untitled Document |
| | Diagnosis: ORSA (oxacillin-resistant Staphylococcus aureus) endocarditis with septic emboli to skin. | | | Only 5% of patients with bacterial endocarditis develop these lesions. | | | The patient's pustules, blood, and CSF were sent for gram stain and culture. |
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http://dermatology.wustl.edu/dermsub/caseofmonth/7-8-2003a.html
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| | Infective Endocarditis in children Pediatric Oncall |
| | X-Ray chest reveals findings compatible with the preexisting heart disease. | | | Serum globulins are increased and rheumatoid factor is elevated in 20% of patients. | | | Endocarditis is preceded by bacteremia, often caused by dental or other surgical procedures. |
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http://www.pediatriconcall.com/fordoctor/DiseasesandCondition/infective_endocarditis.asp
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| | eMedicine - Infective Endocarditis : Article by John L Brusch, MD, FACP |
| | The peripheral lesions of subacute IE are observed in only approximately 20% of patients, compared with 85% in the preantibiotic era. | | | In summary, the indications for performing echocardiography with Doppler in patients with IE are (1) to provide a baseline in proven or highly suggestive cases of IE and (2) to provide a means of documenting complications during therapy. | | | TEE is indicated (1) when mechanical prosthetic valves are present, (2) to detect right-sided lesions, and (3) to visualize myocardial abscesses. |
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http://www.emedicine.com/MED/topic671.htm
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| | Untitled Document |
| | The most effective treatment for swelling in these cases is careful and methodical massaging of the extremities to reduce fluid deposition in these areas. | | | One must be cognizant that the skin lesion may be infectious and communicable, often with antibiotic resistant microorganisms that may infect the embalmer. | | | These lesions will often occur at the groin, neck, axillaries, dorsum of the hand and anticubital fossa. |
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http://www.biomed.lib.umn.edu/hw/intravenous.html
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| | CARDITIS |
| | Intravenous drug abusers commonly have infective endocarditis due to Staphylococcus aureus from contaminated needles. | | | Various conditions lead to endothelial cell damage and predispose a patient to the formation of NBTE. | | | Osler nodes- small, pea-sized subcutaneous, painful erythematous nodules that occur in the pads of the fingers and toes and the thenar eminence. |
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http://www.kcom.edu/faculty/chamberlain/Website/lectures/lecture/CARDITIS.htm
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| | Management of Patients With Valvular Heart Disease Guidelines:Evaluation and Management of Infective Endocarditis |
| | These consequences include valvular vegetations; valvular regurgitation; ventricular dysfunction; and associated lesions such as abscesses, shunts, and ruptured chordae (495). | | | Clinical suspicion of infective endocarditis may be raised by the presence of fever and other systemic symptoms coupled with physical findings such as Osler's nodes, petechiae, Janeway lesions, Roth spots, splenomegaly, and a cardiac murmur. | | | At present, these physical signs are less commonly encountered, and definitive diagnosis is made by demonstrating an offending organism by blood culture. |
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http://www.acc.org/clinical/guidelines/valvular/jac5929fla112.htm
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| | ¡Answer |
| | Finally, steroid and cytotoxic therapy have no effect upon valvular lesions associated with SLE. | | | Without evidence of infection, including multiple, negative blood cultures, antibiotic therapy would not be beneficial. | | | Not only does the patient have no fever, but there is also no sign of embolic phenomena, such as Roth's spots, Janeway lesions, or Osler's nodes. |
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http://usmle.net/step-2/messages2005c/199295.html
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| | Postgraduate Medicine: The many faces of Staphylococcus aureus infection |
| | Pleuritic chest pain or pleural effusion, or both, may complicate lesions of this type if they involve the visceral pleura. | | | Findings resulting from immunologic phenomena, such as splenomegaly, Osler's nodes, positive rheumatoid factor, and immune complex glomerulonephritis, tend to be less common in S aureus endocarditis than in classic subacute endocarditis, such as that caused by viridans streptococci. | | | An important clue to this diagnosis is the presence of focal, rounded, and sometimes cavitary infiltrates on chest radiograph; these infiltrates are the result of septic pulmonary embolization (figure 2: not shown). |
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http://www.postgradmed.com/issues/2001/10_01/weems.htm
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| | Bacterial Infections of the Mouth Including Gingivitis and Periodontitis from Dermatology / Diseases Of The Oral Mucosa |
| | The benefits of antibiotic prophylaxis are not established and in fact only 50% of patients with native valve endocarditis knew they had a valve lesion predisposing infection. | | | Neurological manifestations such as delirium, headache, & meningeal irritation may be caused by mycotic aneurysms. | | | Those at greatest risk are patients with prosthetic heart valves, previous infective endocarditis, cyanotic congenital heart disease, aortic valve disease, mitral regurgitation, patent ductus arteriosus, ventricular septal defect, coarctation of the aorta, and intravenous drug users. |
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http://author.emedicine.com/DERM/topic657.htm
(7836 words)
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| | Janeway lesions - General Practice Notebook |
| | Janeway lesions are painless palmar macules seen in patients with infective endocarditis. | | | The information provided herein should not be used for diagnosis or treatment of any medical condition. | | | Oxbridge Solutions Ltd® is an independent company owned by the authors which does not receive income from any other organisation or individual. |
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http://www.gpnotebook.com/cache/2134179849.htm
(79 words)
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| | Infective endocarditis |
| | - immune complex deposition -> arthralgia, Roth spots, Janeway lesions, focal glomerulonephritis, acute vasculitis | | | - embolization -> splenic and renal infarcts; coronary emboli -> myocardial infarction, emboli from right sided lesions -> pulmonary infarction | | | - Janeway lesions - small flat erythematous, non-tender macules on thenar and hypothenar eminences |
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http://homepage.mac.com/guitarbloke/Surgical_sieve/Cardiovascular/Infective_endocarditis/Infective_endocarditis.html
(530 words)
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| | January syllabus |
| | Predisposition: predisposing heart condition or intravenous drug use | | | Microorganisms: demonstrated by culture or histology in a vegetation, or in a vegetation that has embolized, or in an intracardiac abscess, or | | | Pathologic lesions: vegetation or intracardiac abscess present, confirmed by histology showing active endocarditis |
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http://www.mayo.edu/cme/cardiology/jan_syl.htm
(2211 words)
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| | Gram Positive Bacteria Part I. |
| | IV drug users tend to experience lungs full of septic emboli caused by tricuspid | | | A classic sign is necrosis in the distal extremities (fingers and toes - | | | Janeway lesions) as this is indicative of endocarditis ischemia. |
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http://www.uhmc.sunysb.edu/microbiology/grampos1.html
(1786 words)
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| | Presidential Address to The American Association of Immunologists : The Road Less Traveled by: The Role of Innate ... |
| | Presidential Address to The American Association of Immunologists : The Road Less Traveled by: The Role of Innate Immunity in the Adaptive Immune Response -- Janeway 161 (2): 539 -- The Journal of Immunology | | | Jr Janeway, C. Approaching the asymptote?: evolution and revolution in immunology. | | | Photographs of my forbears: Edward Gamaliael Janeway (left), Theodore Caldwell Janeway (center), and Charles A. Janeway (right). |
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http://www.jimmunol.org/cgi/content/full/161/2/539
(4981 words)
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| | Turner White Communications - Review of Clinical Signs Questions |
| | Osler’s nodes have also been seen in patients with scleroderma. | | | Janeway lesions are usually erythematous and nodular, and may appear hemorrhagic. | | | Splinter hemorrhages have been described in all of the following patients EXCEPT: |
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http://www.turner-white.com/rcs/may00/rcs_may00_endocard.htm
(234 words)
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| | Endocarditis - Wikipedia, the free encyclopedia |
| | Osler's nodes and Janeway lesions (painful subcutaneous lesions in the distal fingers; and painless hemorrhagic cutaneous lesions on the palms and soles, respectively) | | | A new or changing heart murmur, particularly murmurs suggestive of valvular incompetence |
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http://www.wikipedia.org/wiki/Endocarditis
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| | eMedicine - Endocarditis : Article by Keith Marill, MD |
| | One or more classic signs of infective endocarditis are found in as many as 50% of patients. | | | Pathophysiology: Infective endocarditis generally occurs as a consequence of nonbacterial thrombotic endocarditis, which results from turbulence or trauma to the endothelial surface of the heart. | | | Transesophageal echocardiography has a sensitivity of more than 90% for valvular lesions. |
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http://www.emedicine.com/emerg/topic164.htm
(2939 words)
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| | Pediatric Page on Infective Endocarditis - from California Pacific Medical Center's Department of Pediatrics |
| | Endocarditis may affect congenital heart lesions (most commonly, tetralogy of Fallot, VSD, aortic stenosis, PDA and transposition of the great arteries), valves affected by rheumatic heart disease and mitral valve prolapse. | | | Definitive diagnosis of IE includes recovery of a microorganism from culture or histologic study of the heart, an embolized vegetation or an intra-cardiac abscess. | | | Embolization of vegetation occurs in 50% of all cases and may be to the brain, liver, spleen, kidneys, peripheral limbs, and/or lungs. |
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http://www.cpmc.org/advanced/pediatrics/physicians/pedpage-205cardio.html
(818 words)
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| | An approach to the diagnostic use of echocardiography |
| | MV lesions are most likely to embolize and lesions >10mm are more likely to embolize. | | | Oscillating intracardiac mass on valve or supporting structures or in the path of regurgitant jets, or on iatrogenic devices, in the absence of an alternating explanation, or | | | Janeway’s lesions: nontender, hemorrhagic macules on palms and soles--<10%. |
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http://www.med.unc.edu/medicine/web/endocarditis.htm
(858 words)
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| | [No title] |
| | Fever: (38* Vascular phenomena: Arterial emboli, septic pulmonary infarcts, mycotic aneurysm, conjunctival hemorrhages, or Janeway lesions. | | | Nonmobile echogenic densities on the valves may be consistent w/vegetations, but not pathognomonic for infective endocarditis. | | | (Greatest specificity w/mobile and oscillating lesions (freely moveable edge). |
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http://cybermed.ucsd.edu/isp/2002/antons/endocarditis.doc
(735 words)
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| |
| | Catalog of Clinical Images |
| | Janeway Lesion: Flat, painless, erythematous lesions seen on the palm of this patient's hand. | | | For comments or other information contact: Charlie Goldberg, M.D. Copyright ©2005, The Regents of the University of California. |
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http://medicine.ucsd.edu/clinicalimg/Skin-Janeway2.html
(56 words)
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| | MACROLIDES, TETRACYCLINES, AND SULFONAMIDES |
| | -Osler nodes - small painful nodular lesions usually in pads of fingers/toes. | | | CHF may be present if significant valvular insufficiency. | | | -Janeway lesions - hemorrhagic, macular plaques usually seen on palms and soles. |
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http://www.uic.edu/pharmacy/courses/pmpr342/teichner/endocarditis.html
(2065 words)
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| | INFECTIVE ENDOCARDITIS IN A NEONATE |
| | The clinical and laboratory features reported in various combinations are hepatosplenomegaly, fever, skin abscesses, new or changing cardiac murmurs, congestive cardiac failure, presence of embolic phenomenon, arthritis, etc. Osler's nodes, Roth's spots or Janeway lesions, and clinical evidence of central nervous system involvement are more uncommon features of neonatal IE. |
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http://www.kfshrc.edu.sa/annals/173/96-252.html
(1268 words)
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| | Case Based Pediatrics Chapter |
| | No antibiotics are needed, because this particular patient has no risk factors for infective endocarditis. | | | On the other hand, the subacute course is characterized as an insidious, flu-like syndrome, associated with malaise, anorexia, +/- fever. | | | The patient had positive blood cultures (1 major), and (3 minors) fever greater than 38 degrees C, a predisposing structural cardiovascular lesion (VSD), and evidence of an immunologic phenomenon (microscopic hematuria). |
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http://www.hawaii.edu/medicine/pediatrics/pedtext/s07c05.html
(3468 words)
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| | Endocarditis |
| | Embolic lesions to brain (confusion), to kidney (hematuria), to lungs (hemoptysis), spleen (L flank pain), coronaries (MI). | | | These S and S can be present also in ABE but given short duration of onset are less frequent than in SBE. | | | The SBE pt has 1 - 2 wks of wt loss, low grade fevers, night sweats, vascular/collagen/immune manifestations such as arthritis, Osler nodes, Janeway lesions, Roth spots and possible embolic lesions to brain/lung/kidney. |
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http://www.erwize.com/Quick_Reference/Professionatls/ID/Endocarditis/body_endocarditis.html
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| | JANEWAY |
| | I don't know what you told Janeway, but you got him eatin' right out of your hand. | | | The following table summarizes the usage of "JANEWAY" based on a population census conducted in the United States. | | | Ranks and frequencies are based on all names reported and classified. |
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http://www.websters-online-dictionary.org/definition/JANEWAY
(337 words)
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| | Common Peripheral Manifestations of Infective Endocarditis. |
| | Janeway's lesions (Panel D) are nontender, erythematous, hemorrhagic, or pustular lesions, often on the palms or soles. | | | Osler's nodes (Panel C)are tender, subcutaneous nodules, often in the pulp of the digits or the thenar eminence. |
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http://www.rjmatthewsmd.com/Definitions/pop/201afig.htm
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| | CDC - Emerging Issues in Infective Endocarditis |
| | Credited by Osler as first to observe cutaneous nodes (named "Osler's nodes" by Libman) in patients with endocarditis | | | Believed endocarditis could appear during various infections; noted translocation of respiratory pathogen from pulmonary lesion to valve through blood | | | Demonstrated various bacteria introduced to bloodstream could cause endocarditis on valve that had previous lesion |
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http://www.cdc.gov/ncidod/EID/vol10no6/03-0848.htm
(3762 words)
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| | Subacute Bacterial Endocarditis Cutaneous lesions. |
| | Some think that these too may be more vasculitic then embolic. | | | Gram positive cocci can be seen with biopsy of the lesions. |
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http://medocs.ucdavis.edu/der/420/Dermatologic%20Emergencies/tsld056.htm
(33 words)
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| | Welcome to DailySentinel! |
| | Registered site users, you may edit your profile. | | | red painless skin spots, located on the palms and soles (called Janeway lesions) |
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http://www.dailysentinel.com/health/healthfd/shared/health/adam/ency/article/001098sym.html
(268 words)
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| | MMID - Exam 3 2002: Question 18 Choice 4 |
| | D) It is responsible for Janeway lesions and Osler nodes. | | | How does the Venturi effect affect bacterial endocarditis? |
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http://medinfo.ufl.edu/cgi-bin/quiz.cgi?mmid3_2002r/q18a4
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