Abstract
The pathogenesis of Osler's nodes and Janeway lesions has been disputed since their first description more than 100 years ago. Hypersensitivity vasculitis has been suggested, whereas others have sought to prove that septic microemboli are the cause. Little histologic evidence has been provided, however, to confirm the suspicion that the skin lesions in acute bacterial endocarditis are secondary to septic emboli. We describe a patient with fulminant methicillin-resistant Staphylococcus aureus endocarditis and skin lesions that cultured the same organism. Histologic examination revealed gram-positive cocci in clusters and chains within the lumen of vessels.
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