Janeway lesions
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Janeway lesions are non-tender, small erythematous or haemorrhagic macular or nodular lesions on the palms or soles only a few millimeters in diameter that are pathognomonic of infective endocarditis.[1] Pathologically, the lesion is described to be a microabscess of the dermis with marked necrosis and inflammatory infiltrate not involving the epidermis, which is due to the deposition of circulating immune complexes in small blood vessels.[1]
Overview
- Janeway lesions are irregular, flat, painless, erythematous macules found on the palms, soles, thenar and hypothenar eminences of the fingertips, hands and plantar surfaces of the toes.
- Stigmata of infectious endocarditis
- Considered a criterion (albeit minor) of vascular phenomena
Etymology
They are named after Edward G. Janeway (1841–1911), a professor of medicine with interests in cardiology and infectious disease.[1]
Differential Diagnosis
In alphabetical order. [1] [1]
- Acute bacterial endocarditis
- Coxsackievirus
- Cutaneous vasculitis
- Disseminated Intravascular Coagulation (DIC)
- Echovirus
- Erythema multiforme
- Idiopathic thrombocytopenia purpura
- Meningococcemia
- Polyarteritis Nodosa
- Rocky Mountain Spotted Fever
- Secondary syphilis
- Subacute bacterial endocarditis
- Systemic Lupus Erythematosus
- Thrombotic thrombocytopenic purpura
- Typhoid Fever
Diagnosis
History and Symptoms
- IV drug abuse
- Infective endocarditis
- Structural heart disease
- Heart valve injury/replacement
- Family history of autoimmune disorders
- HIV status
- Mucosal bleeding
- Head/neck or lung infection
- Tick exposure
- Constitutional symptoms
Laboratory Findings
- Blood cultures
- Complete blood count (CBC) with peripheral smear
- Antinuclear antibody (ANA)
- Rapid plasma reagin (RPR)
- Erythrocyte sedimentation rate (ESR)
- Antistreptolysin O antibodies (ASO)
- Urinalysis
- Coagulation studies
- Anti-SM antibodies
- Anti-dsDNA antbodies
Chest X Ray
Echocardiography or Ultrasound
Other Diagnostic Studies
- Possible biopsy
Acute Pharmacotherapies
- IV antibiotics
- Antibiotic prophylaxis
- Treat all underlying etiologies
Chronic Pharmacotherapies
- Antibiotic therapy for bacterial endocarditis
Surgery and Device Based Therapy
- Valve replacement for bacterial endocarditis
Indications for Surgery
- If all other medical therapy fails (bacterial endocarditis)
References
See also
WikiDoc Research Resources for Janeway lesions | |
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| Articles on Janeway lesions | Most recent articles on Janeway lesions • Most cited articles on Janeway lesions • Review articles on Janeway lesions • Articles on Janeway lesions in N Eng J Med, Lancet, BMJ |
| Media (Slides, Video, Images, MP3) on Janeway lesions | Powerpoint slides on Janeway lesions • Images of Janeway lesions • Photos of Janeway lesions • Podcasts & MP3s on Janeway lesions • Videos on Janeway lesions |
| Evidence Based Medicine Regarding Janeway lesions | Cochrane Collaboration on Janeway lesions • Bandolier on Janeway lesions • TRIP on Janeway lesions |
| Cost Effectiveness of Janeway lesions | Cost Effectiveness of Janeway lesions |
| Clinical Trials Involving Janeway lesions | Ongoing Trials on Janeway lesions at Clinical Trials.gov • Trial results on Janeway lesions • Clinical Trials on Janeway lesions at Google |
| Guidelines / Policies / Government Resources (FDA/CDC) Regarding Janeway lesions | US National Guidelines Clearinghouse on Janeway lesions • NICE Guidance on Janeway lesions • NHS PRODIGY Guidance • FDA on Janeway lesions • CDC on Janeway lesions |
| Textbook Information on Janeway lesions | Books and Textbook Information on Janeway lesions |
| Pharmacology Resources on Janeway lesions | Dosing of Janeway lesions • Drug interactions with Janeway lesions • Side effects of Janeway lesions • Allergic reactions to Janeway lesions • Overdose information on Janeway lesions • Carcinogenicity information on Janeway lesions • Janeway lesions in pregnancy • Pharmacokinetics of Janeway lesions • |
| Genetics, Pharmacogenomics, and Proteinomics of Janeway lesions | Genetics of Janeway lesions • Pharmacogenomics of Janeway lesions • Proteomics of Janeway lesions |
| Newstories on Janeway lesions | Janeway lesions in the news • Be alerted to news on Janeway lesions • News trends on Janeway lesions |
| Commentary on Janeway lesions | Blogs on Janeway lesions |
| Patient Resources on Janeway lesions | Patient resources on Janeway lesions • Discussion groups on Janeway lesions • Patient Handouts on Janeway lesions • Directions to Hospitals Treating Janeway lesions • Risk calculators and risk factors for Janeway lesions |
| Healthcare Provider Resources on Janeway lesions | Symptoms of Janeway lesions • Causes & Risk Factors for Janeway lesions • Diagnostic studies for Janeway lesions • Treatment of Janeway lesions |
| Continuing Medical Education (CME) Programs on Janeway lesions | CME Programs on Janeway lesions |
| International Resources on Janeway lesions | Janeway lesions en Espanol • Janeway lesions en Francais |
| Business Resources on Janeway lesions | Janeway lesions in the Marketplace • Patents on Janeway lesions |
| Informatics Resources on Janeway lesions | List of terms related to Janeway lesions |
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
