Splinter hemorrhage (patient information)

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Splinter hemorrhage


What are the symptoms?

What are the causes?

Who is at highest risk?


When to seek urgent medical care?

Treatment options

Where to find medical care for splinter hemorrhage?


What to expect (Outlook/Prognosis)?

Possible complications

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Risk calculators and risk factors for splinter hemorrhage

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Splinter hemorrhages are small areas of bleeding (hemorrhage) under the fingernails or toenails. Splinter hemorrhages look like thin, red to reddish-brown lines of blood under the nails. They run in the direction of nail growth.

They are named splinter hemorrhages because they look like a splinter under the fingernail.

What causes splinter hemorrhages?

Splinter hemorrhages can occur with infection of the heart valves (endocarditis). They may be caused by vessel damage from swelling of the blood vessels (vasculitis) or tiny clots that damage the small capillaries (microemboli). Injury to the nail can also cause splinter hemorrhages.

When to seek urgent medical care?

Contact your health care provider if:

  • You notice splinter hemorrhages and you haven't had any recent injury to the nail

Note: Splinter hemorrhages usually appear late in endocarditis. Likely other symptoms will cause you to visit your health care provider before splinter hemorrhages appear.


Your health care provider will examine you to determine the cause of splinter hemorrhages. The health care provider may ask you the following medical history questions:

  • When did you first notice this?
  • Have you had an injury to the nails recently?
  • Do you have endocarditis, or has your health care provider suspected that you have endocarditis?
  • What other symptoms do you have, such as shortness of breath, fever, general ill feeling, or muscle aches?

Physical examination may include special attention to the heart and blood circulation systems.

Laboratory studies may include:

In addition, your health care provider may order:

After seeing your health care provider, you may want to add a diagnosis of splinter hemorrhages to your personal medical record.

Treatment options

There is no specific care for splinter hemorrhages. Follow your health care provider's instructions for treating endocarditis.

Where to find medical care for splinter hemorrhages?

Directions to Hospitals Treating Splinter Hemorrhages