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March 2010

Janeway Lesions, Osler Nodes, or Neither?

Author Affiliations

Author Affiliation: Hua Chiew Hospital, Bangkok, Thailand.

Arch Neurol. 2010;67(3):373. doi:10.1001/archneurol.2010.8

Navi and colleagues1 describe a woman with right-sided weakness and difficulty speaking who was subsequently diagnosed with tumor emboli of metastatic lung carcinoma. The authors mentioned Janeway lesions. I was wondering how they distinguished Janeway lesions from Osler nodes in the patient with global aphasia. Both signs are similar; the only essential diagnostic difference is that Janeway lesions are not tender, while Osler nodes are.2,3 Lastly, it is noteworthy that Janeway lesions and Osler nodes are pathognomonic signs of infective endocarditis.2,3

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