INFECTIVE ENDOCARDITIS

Q. The erythematous painless lesions on palms in the setting of infective endocarditis are called?
A. Osler nodes
B. Roth spots
C. Splinter hemorrhages
D. Janeway lesions
E. Palpable purpura

Ans: D.

In the setting of IE, emboli from the vegetative valvular lesion can lodge in the distal vasculature and immune complexes can form, leading various lesion such as- Osler nodes, Roth spot, Splinter hemorrhages, Janeway lesions.

 Roth spots – is due to Immunologic phenomena- Retinal hemorrhage with a central area of clearing.

Osler nodes- also  Immunologic lesion- Erythematous painful nodes at the tips of digits.

Janeway lesion- Vascular  etiology- Erythematous painless macules lesions on the palms and soles .

Splinter haemorrhage-  Vascular cause- Petechiae underneath the hemorrhages nail bed.