Janeway Lesions | Osler Nodes | FAQ | World Health Support

Janeway Lesions

Janeway Lesions

Janeway lesions are painless, rare, non-tender, often haemorrhagic (bleeding into the skin) lesions seen most commonly on the palms and soles. These lesions are particularly seen on the base of the thumb, tips of the fingers, and plantar surfaces of the toes. Septic emboli causes this lesions.

Janeway Lesions are usually seen with the acute form of bacterial endocarditis. It generally lasts for a few days to a few weeks. They are painless, non-itchy, and macular (mainly purple or brown erythematous macular lesions).

What is bacterial endocarditis?

Bacterial endocarditis is an infection of the lining of the heart. Various bacteria causes this infection. The bacteria causing this infection include various species of staphylococcus, pseudomonas, streptococcus and other organisms.

These bacteria get access to the heart via the bloodstream. So, the infection elsewhere in the body may apparent. Some bacteria can cause infection in normal heart valves.

The symptoms of bacterial endocarditis may include fever, shortness of breath, lethargy, chest pain or palpitations.


Janeway Lesions vs Osler’s Nodes:

Janeway lesions are often indistinguishable from Osler’s nodes. Actually Janeway lesions and Osler’s nodes are almost similar.  Janeway lesions does not  present with tenderness. On the otherhand, Osler’s nodes present with tenderness. This is the major difference between them.

Topics Janeway Lesions Osler’s Nodes
Placement On the palm and soles. On the tip of the finger, or toes.
Pain It is not painful It is painful
Caused By Janeway Lesions is caused by septic microemboli. Osler’s Nodes is caused by localized immunological-mediated response .
Presence Without tenderness With tenderness


Symptoms of Janeway Lesions:

There are some symptoms of janeway lesions. Some major and important symptoms are mentioned here:

  • Lesions are only a few millimeters in diameter found on the palms and soles.
  • No pain of those lesions
  • The lesions are flat and red or purple in color


Janeway Lesions


What is the treatment of Osler nodes?

  • Intravenous antibiotics
  • Valve surgery


Tests for Osler nodes:

These tests will be helpful to diagnosis Osler nodes. Some of the tests are included here:

  • Blood tests
  • Urine tests
  • ECG
  • Chest X-ray
  • Echocardiogram (heart ultrasound scan)
  • A skin biopsy

Where are Osler nodes?

The size of the Osler nodes is split pea–sized. They are tender nodules located on the pads of the fingers and toes.



Are Janeway lesions painful?

Janeway lesions are painless. It is macular, and haemorrhagic lesions that occur most commonly on the on the palmar surface, plantar surfaces of the toes and soles.

Are Janeway lesions itchy?

This type of lesions are non-itchy. They are also non-tender, purple or brown erythematous macular lesions at the base of both palms.


What are the symptoms of infective endocarditis?

The symptoms of Infective Endocarditis (IE) usually start with fever (102°F – 104°F). There are some other symptoms of IE. They are:

  • Chills
  • Fast heart rate
  • Persistent cough
  • Fatigue
  • Swelling in the feet, or legs
  • Sweating at night
  • Pain in the joints as well as muscles
  • Fever
  • Chest pain
  • Weakness
  • Blood in the urine (abnormal urine color)
  • Red skin rash
  • White spots in the mouth or tongue
  • Short breathing
  • Sore throat
  • Sinus congestion
  • Nausea
  • Body weight loss


Janeway Lesions


What are the most common organisms that cause infective endocarditis?

The most common organisms that cause infective endocarditis are streptococci and staphylococci, and enterococci.


Do Janeway lesions blanch?

No, Janeway lesions do not blanch on pressure. We know that janeway lesions is hemorrhagic lesions. So they do not blanch.


Can endocarditis cause rashes?

Sometimes diarrhea, rashes, itching or joint pain may be seen in case of many patients. You should tell your doctor about rashes and other symptoms before using antibiotics.


What do Osler nodes look like?

Osler nodes look like red-purple, slightly raised, tender lumps, generally with a pale centre.

What is a Roth spot?

A Roth spot is a red spot caused by hemorrhage. This is commonly seen in case of acute bacterial endocarditis with a characteristic pale white center.