What Are Janeway Lesions? Symptoms, Causes, and More

Janeway lesions are painless dark red or purple spots that form on the palms, soles, or under the toes or fingers. They are a common sign of infective endocarditis. Infective endocarditis is an infection of the heart valves or lining. It happens when bacteria, such as staphylococcus aureus, enter the bloodstream and settle in the heart lining.

Most cases of Janeway lesions occur with Trusted Source American Journal of Clinical Nutrition Peer reviewed journal Go to source Osler’s nodes. Osler’s nodes are tender red-to-purple lumps that form on the fingers or toes.

Read on to learn more about Janeway lesions, including their causes, symptoms, and treatment.

Janeway lesions are skin patches that develop on the palms and feet. They usually last Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source a few days to a few weeks before disappearing.

Most cases of the condition indicate infective endocarditis, a heart infection. Sometimes, it can signify other conditions, such as systemic lupus erythematosus (SLE).

Experts have identified Trusted Source JAMA Peer reviewed journal Go to source the peculiar characteristics of Janeway lesions as follows:

• Non-tender: The lesions do not hurt when you touch them.
• Hemorrhagic: The lesions typically bleed into the skin.
• Necrotic: The lesions consist of dead tissue.

Janeway lesions are a common manifestation of infective endocarditis. 

Infective endocarditis causes inflammation in the heart’s valves and lining. It is very rare Trusted Source American Journal of Clinical Nutrition Peer reviewed journal Go to source but can be fatal.

According to the American Heart Association (AHA) Trusted Source American Heart Association Highly respected national organization Go to source , there are two types of the condition:

• Acute type: This develops suddenly and progresses quickly. 
• Subacute or chronic type: This develops slowly over weeks to months.

Other symptoms of infective endocarditis include: 

• fever and chills
• lethargy
• night sweats
• shortness of breath
• aching joints and muscles
• chest pain or palpitations

In some cases, splinter hemorrhages may also occur Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source with infective endocarditis. Splinter hemorrhages are small areas of bleeding under the nail. They result when the blood vessels under the nail bed get damaged.

Seek immediate emergency treatment if you have Janeway lesions or other symptoms of endocarditis.

Janeway lesions commonly occur with Osler’s nodes. 

Osler’s nodes are also a type of skin lesion. They typically Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source have raised edges and a red-to-purple color with a pale center. They typically also have a pale center. 

There are many similarities between Janeway lesions and Osler’s nodes. However, there are noteworthy differences, too.

Osler’s nodes are usually painful Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source , but Janeway lesions are not. Also, Osler’s nodes typically appear on the fingers and toes, but Janeway lesions generally affect the palms and soles.

Janeway lesions usually have the following features:

• Borders: irregular or ill-defined 
• Elevation: flat
• Color: red to bluish-red 
• Distribution: multiple or in clusters 

They may be slightly harder to spot in people with dark skin because the lesions may appear a similar color to a person’s skin.

Show your signs to your doctor for prompt diagnosis and treatment.

Janeway lesions are a common sign of infective endocarditis. Infective endocarditis results when bacteria enter the bloodstream and settle in the heart’s lining.

Several types of bacteria can cause infective endocarditis, including:

• staphylococci
• streptococci
• enterococci
• pseudomonas
• bartonella

Staphylococci, streptococci, and enterococci are responsible Trusted Source American Journal of Clinical Nutrition Peer reviewed journal Go to source for most cases of infective endocarditis.

Other causative pathogens include: 

• hemophilus species
• aggregatibacter species
• cardiobacterium species
• eikenella species
• kingella species

The following factors can increase Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source a person’s risk of infective endocarditis:

• having a structural or congenital heart disease
• having prosthetic heart valves
• having previously undergone invasive procedures
• using intravenous medicines

The exact reason infective endocarditis causes Janeway lesions is uncertain. However, experts believe bacterial growth in the blood vessels may be involved.

Your doctor will treat Janeway lesions by addressing infective endocarditis. 

The main treatment Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source for infective endocarditis is antibiotics. Examples of antibiotics include:

• penicillins (Piperacillin)
• cephalosporins (Cefazolin)
• carbapenems (Doripenem)

Your doctor will initially conduct some blood tests to determine the most suitable antibiotic to give you. They will also admit you to the hospital so you can receive the antibiotic intravenously or through a drip.

If your condition calls for it, your doctor may complement the antibiotic therapy with surgery. Surgery will focus on repairing the damaged heart valve and draining any abscesses.

Overall, the duration of your treatment will depend Trusted Source American Journal of Clinical Nutrition Peer reviewed journal Go to source on the pathogen involved. 

Experts say Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source the appearance of Janeway lesions and Osler’s nodes may indicate a poor outlook for infective endocarditis. 

The lesions may also occur with endocarditis-related complications, such as: 

• congestive failure
• sepsis
• meningitis
• enlarged spleen
• stroke
• kidney damage
• heart attack and heart failure
• heart block and heart valve damage
• brain abscesses

Infective endocarditis can often be life threatening Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source without prompt treatment. It is important to seek early diagnosis and treatment if you have symptoms. It also helps to take measures to lower your risk of the condition.

These measures include:

• observing proper oral hygiene
• taking good care of your skin
• visiting your dentist for a dental checkup every 6 months
• taking preventive antibiotics if you have a high risk for infective endocarditis

Remember to speak with your doctor before using preventive antibiotics.

Janeway lesions are skin patches that develop on the palms and feet. They usually indicate infective endocarditis. 

Infective endocarditis causes inflammation in the heart valves or lining. It results when bacteria, such as staphylococcus aureus, enter the bloodstream and settle in the heart lining.

Janeway lesions commonly occur with Osler’s nodes. Osler’s nodes are painful spots with raised edges and a red-to-purple color. 

Treatment for Janeway lesions focuses on addressing infective endocarditis. Methods include antibiotics and surgery.

Make an appointment with your doctor if you have a Janeway lesion or other symptoms of infective endocarditis.