Janeway Lesions

Definition

Janeway lesions are small, painless, erythematous (reddish) macules or nodules that occur on the palms and soles of individuals with infective endocarditis, a serious bacterial infection of the heart valves or lining. These lesions are considered a classic clinical sign of this condition.

5 Must Know Facts For Your Next Test

1. Janeway lesions are typically painless, unlike the tender Osler's nodes that may also occur in infective endocarditis.
2. These lesions are thought to result from immune complex deposition in the skin, similar to the pathogenesis of Osler's nodes.
3. The presence of Janeway lesions, along with other clinical signs like fever and heart murmurs, helps diagnose infective endocarditis.
4. Janeway lesions are more commonly seen in acute, rapidly progressing cases of infective endocarditis rather than in subacute or chronic cases.
5. Prompt recognition and treatment of infective endocarditis, the underlying cause of Janeway lesions, is crucial to prevent serious complications like heart failure or sepsis.

Review Questions

• Describe the clinical features and appearance of Janeway lesions.
  • Janeway lesions are small, painless, erythematous (reddish) macules or nodules that typically appear on the palms and soles of individuals with infective endocarditis. They are considered a classic clinical sign of this serious bacterial infection of the heart valves or lining. Unlike the tender Osler's nodes that may also occur in infective endocarditis, Janeway lesions are typically painless and thought to result from immune complex deposition in the skin.
• Explain the significance of Janeway lesions in the diagnosis and management of infective endocarditis.
  • The presence of Janeway lesions, along with other clinical signs like fever and heart murmurs, helps diagnose infective endocarditis, a life-threatening infection of the heart's inner lining or valves. Prompt recognition and treatment of the underlying infective endocarditis is crucial to prevent serious complications like heart failure or sepsis. Janeway lesions are more commonly seen in acute, rapidly progressing cases of infective endocarditis rather than in subacute or chronic cases, underscoring the need for timely intervention.
• Discuss the pathogenesis of Janeway lesions and their relationship to the immune response in infective endocarditis.
  • Janeway lesions are thought to result from the deposition of immune complexes in the skin, similar to the pathogenesis of Osler's nodes observed in infective endocarditis. In this condition, the body's immune system mounts a response to the bacterial infection of the heart, leading to the formation of these immune complexes. The deposition of these complexes in the small blood vessels of the palms and soles manifests as the characteristic Janeway lesions. Understanding the underlying immune mechanisms involved in the development of Janeway lesions provides important insights into the pathophysiology of infective endocarditis and guides the appropriate clinical management of this serious infection.

Related terms

Infective Endocarditis: A life-threatening infection of the heart's inner lining or valves, often caused by bacteria entering the bloodstream and settling on damaged heart tissue.

Osler's Nodes: Tender, erythematous (red) nodules that appear on the pads of the fingers and toes in individuals with infective endocarditis, thought to be immune complexes deposited in the skin.

Petechiae: Small, pinpoint, non-blanching red or purple spots on the skin caused by capillary bleeding, which can be a sign of infective endocarditis or other systemic infections.