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"Janeway"
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Booked to die
Former Denver policeman and knowledgeable book collector Cliff Janeway investigates the murder of a bookscout.
Book
Streptobacillus moniliformis and IgM and IgG Immune Response in Patient with Endocarditis
We describe a case of endocarditis caused by Streptobacillus moniliformis bacteria, a known cause of rat-bite fever, in a 32-year-old woman with pet rats in Germany. The patient had a strong serologic response, with high IgM and IgG titers. Serologic analysis is a promising tool to identify S. moniliformis bacterial infection.
Journal Article
John Alexander Mullin (1835–1899): The Canadian Physician who first described Osler’s Nodes
Sir William Osler (1849–1919), who became Regius Professor of Medicine at Oxford in 1905, first drew attention in 1909 to the painful nodes in subacute bacterial endocarditis, which now carry his eponym, and he published an account in the Quarterly Journal of Medicine, which he helped establish. Attention is drawn to the often overlooked fact that it was a Dr John Alexander Mullin (1835–1899) of Hamilton, Ontario, Canada, who first drew the attention of Sir William Oster to their occurrence. Confusion arose over the relationship between Osler’s nodes and the skin lesions described by Theodore Caldwell Janeway (1872–1917), which are generally non-tender and found in acute bacterial endocarditis. The evidence is that there is essentially no difference since their pathogenesis and histological findings are identical.
Journal Article
The Fall of the House of Roosevelt
In the 1930s a band of smart and able young men, some still in their twenties, helped Franklin D. Roosevelt transform an American nation in crisis. They were the junior officers of the New Deal. Thomas G. Corcoran, Benjamin V. Cohen, William O. Douglas, Abe Fortas, and James Rowe helped FDR build the modern Democratic Party into a progressive coalition whose command over power and ideas during the next three decades seemed politically invincible. This is the first book about this group of Rooseveltians and their linkage to Lyndon Johnson’s Great Society and the Vietnam War debacle. Michael Janeway grew up inside this world. His father, Eliot Janeway, business editor of Time and a star writer for Fortune and Life magazines, was part of this circle, strategizing and practicing politics as well as reporting on these men. Drawing on his intimate knowledge of events and previously unavailable private letters and other documents, Janeway crafts a riveting account of the exercise of power during the New Deal and its aftermath. He shows how these men were at the nexus of reform impulses at the electoral level with reform thinking in the social sciences and the law and explains how this potent fusion helped build the contemporary American state. Since that time efforts to reinvent government by \"brains trust\" have largely failed in the U.S. In the last quarter of the twentieth century American politics ceased to function as a blend of broad coalition building and reform agenda setting, rooted in a consensus of belief in the efficacy of modern government. Can a progressive coalition of ideas and power come together again? The Fall of the House of Roosevelt makes such a prospect both alluring and daunting.
eBook
Unilateral Osler nodes, Janeway lesions and splinter haemorrhages associated with surgical arterio-venous fistula infection: a case report
Background
Osler’s nodes, Janeway lesions and splinter haemorrhages are cutaneous manifestations of infective endocarditis. They occur due to vascular occlusion by septic emboli and a resulting localized vasculitis. They are usually bilateral. We report a case of unilateral Osler’s nodes, Janeway lesions and splinter haemorrhages due to an ipsilateral surgical arterio-venous fistula infection.
Case presentation
A fifty-two-year-old Sri Lankan female with end stage kidney disease presented with fever for five days with blurred vision, pain and redness of the right eye. She had a left brachio-cephalic arterio-venous fistula (AVF) created one month back. She complained of a foul-smelling discharge from the surgical site for past three days. Redness of the right eye with a hypopyon was noted. AVF site over the left cubital fossa was infected with a purulent discharge. Osler’s nodes, Janeway lesions and splinter haemorrhages were noted in the distal fingers, thenar and hypothenar eminences of the left hand. Right hand and both feet were normal. No cardiac murmurs were heard. Blood cultures, vitreous sample cultures and pus cultures from the fistula site were all positive for methicillin sensitive
Staphylococcus aureus
. Infective endocarditis was excluded by a trans-oesophageal echocardiogram. She was treated with IV flucloxacillin and surgical excision of the AVF.
Conclusion
Infections of AVF can result in septic emboli formation which can have both anterograde arterial embolization and retrograde venous embolization. Arterial embolization can result in unilateral Osler’s nodes, Janeway lesions and splinter haemorrhages. Venous embolization can cause metastatic infections in the systemic and pulmonary circulations.
Journal Article
Early Infective Endocarditis Associated with an Amplatzer Atrial Septal Occluder Device in a 14-Year-Old Male
Infective endocarditis (IE) associated with an ASD device, particularly in the early post-procedure period, is extremely rare. We report a case of infective endocarditis presenting with embolic complications and vegetations on the device that were only seen on transesophageal echocardiography, necessitating device removal.
Journal Article
Extended Janeway lesions in Enterobacter infective endocarditis: a case report
Background
Infective endocarditis is a rare but serious infection of the heart valves, with various clinical manifestations. Diagnosis relies on the modified Duke criteria, in which Janeway lesions can be an important diagnostic feature.
Case presentation
We report a case of a Middle Eastern male patient in his mid-60s with history of ischemic heart disease, diabetes mellitus, chronic kidney disease, and hypertension who presented with respiratory symptoms and extensive skin lesions. A skin biopsy confirmed the lesions as Janeway lesions, assisting in the diagnosis of infective endocarditis caused by
Enterobacter
species. Despite aggressive antimicrobial therapy, the patient’s clinical condition failed to improve, highlighting the challenges in managing infections caused by this organism.
Conclusion
This case highlights the importance of recognizing atypical manifestations of infective endocarditis and utilizing diagnostic tools, such as skin biopsy, for accurate diagnosis. It emphasizes the need for effective management strategies in extended cases caused by uncommon organisms such as
Enterobacter
.
Journal Article
An unusual presentation of subacute Haemophilus parainfluenzae endocarditis in a low-risk woman treated by minimally invasive mitral valve repair: a case report
Background
HACEK endocarditis is usually insidious and can often be difficult to diagnose due to the slow-growing nature of the organisms. This report presents our experience in treating a patient with
Haemophilus parainfluenzae
endocarditis.
Case presentation
We describe the case of a previously fit and well 23 year-old woman who presented to her local emergency department with a four-week history of persistent febrile illness. She had associated nausea, vomiting, and lethargy. This was preceded by an episode of mucopurulent rhinorrhoea. She was treated empirically with oral amoxicillin for a putative diagnosis of rhinosinusitis. Initially, her symptoms abated, however, she was readmitted with high fevers and a new pansystolic murmur. Transthoracic echocardiography revealed a large, mobile, echogenic mass, tethered to the posterior mitral valve leaflet (PMVL) and mild mitral regurgitation (MR). On examination, she had multiple non-tender, erythematous macules on the plantar surface of her feet, consistent with Janeway lesions. Two separate blood cultures grew
H. parainfluenzae
. Infectious diseases recommended a four-week course of intravenous ceftriaxone. Transesophageal echocardiography demonstrated a perforation within the P3 segment of the PMVL. Subsequently, the patient underwent mitral valve repair surgery with an uneventful recovery.
Conclusions
Our case highlights the importance of promptly diagnosing HACEK endocarditis. A prolonged course of antibiotic therapy can be lifesaving, and surgery is often necessary to address complications such as perforation within the mitral valve leaflets. In our patient, we were able to perform a sliding P2 leaflet plasty for good quality repair of the mitral valve, through a minimally invasive right anterior thoracotomy.
Journal Article