| Abstract: |
Replies to the comments made by Weekitt Kittisupamongkol (see record 2010-05207-023) on the original authors' article (see record 2009-17817-022). Our patient was aphasic, she did not grimace, moan, or withdraw to palpation of the lesions, so there appeared to be no discomfort associated with them, making them Janeway lesions. Janeway lesions and Osler nodes are often thought to be pathognomonic for infective endocarditis. However, they are manifestations of distal cutaneous vascular insufficiency, which can occur from emboli from any source, including tumor and nonbacterial thrombotic endocarditis or vascular inflammation due to immune complex deposition as a consequence of chronic bacterial infection. (PsycINFO Database Record (c) 2010 APA, all rights reserved). |
