What are Janeway lesions indicative of?

Janeway lesions are small, nontender, erythematous or hemorrhagic macules typically found on the palms and soles. They are associated specifically with infective endocarditis, particularly in cases caused by bacteremia from various organisms, including Staphylococcus aureus and Streptococcus viridans.

These lesions result from septic emboli that originate from the heart valves and lodge in the dermal capillaries, causing localized ischemia and hemorrhage. The presence of Janeway lesions can help in the clinical diagnosis of endocarditis, especially when considered alongside other physical findings such as petechiae, Osler nodes, and splinter hemorrhages.

Understanding the context of Janeway lesions is critical, as they represent a unique manifestation of endocarditis, differentiating it from other conditions that might cause similar skin findings but are unrelated to cardiac infections.