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December 1966

Occurrence of the Janeway Lesion in Mycotic Aneurysm

Author Affiliations


From the Institute for Cardiopulmonary Diseases, Scripps Clinic and Research Foundation, La Jolla. Drs. Cross and Ellis are Fellows in Cardiology and National Institutes of Health trainees.

Arch Intern Med. 1966;118(6):588-591. doi:10.1001/archinte.1966.00290180064013

DIGITAL phenomena occurring in bacterial infections, and particularly celebrated in subacute bacterial endocarditis, have fascinated physicians for 75 years. Petechiae, splinter hemorrhages, and Osler's nodes are the more commonly known and looked for manifestations which now, as in the past, have pointed to the heart as the source of infection.1 The Janeway lesion 2 is as old and considered as pathognomonic of endocarditis 3 as the Osler's node, but it is less well known and much less commonly identified.

This paper reports the multiple digital manifestations observed in two patients with Pseudomonas infections involving the brachial arterial wall and particularly the occurrence of the Janeway lesion.

Report of Cases 

Case 1.  —A 58-year-old house painter underwent selective celiac-axis angiography because of abdominal pain. A left antecubital cut down with brachial arteriotomy was used to introduce the angiographic catheter. The vessel was closed with 5-0 silk sutures and the

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