Splinter hemorrhages are best described as

Splinter hemorrhages are best described as

• A. Small, linear, red or brown streaks under the nails, indicative of embolic phenomena in infective endocarditis.
• B. Painless erythematous macules on the palms.
• C. Painful nodules on fingers.
• D. Pigmented patches on the lips.

Answer: (A)

Splinter hemorrhages are tiny, linear red or brown streaks that run under the nails from microscopic bleeding in the nail bed due to embolic or vascular phenomena associated with infective endocarditis. They arise when small emboli from endocardial vegetations or fragile capillaries cause capillary bleeding beneath the nail, and the streaks grow out with the nail over time. This peripheral sign supports endocarditis in the right clinical context, even though it isn’t specific. Other options describe different endocarditis stigmata—Janeway lesions are painless red macules on the palms/soles, Osler nodes are painful nodules on the fingers, and pigmented patches on the lips are not typical findings—so the nail-bed linear streaks best fit splinter hemorrhages.

Splinter hemorrhages are tiny, linear red or brown streaks that run under the nails from microscopic bleeding in the nail bed due to embolic or vascular phenomena associated with infective endocarditis. They arise when small emboli from endocardial vegetations or fragile capillaries cause capillary bleeding beneath the nail, and the streaks grow out with the nail over time. This peripheral sign supports endocarditis in the right clinical context, even though it isn’t specific. Other options describe different endocarditis stigmata—Janeway lesions are painless red macules on the palms/soles, Osler nodes are painful nodules on the fingers, and pigmented patches on the lips are not typical findings—so the nail-bed linear streaks best fit splinter hemorrhages.