Splinter Haemorrhage

Dr. A. Nagarajan*

Department of Pulmonology, Kauvery Hospital, Cantonment, Trichy

Correspondence: nagapulmo@gmail.com

History

A 40 years old gentleman presented with three months history of fever and chills. He also had exertion dyspnea. On general examination, we found nail changes.

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What is your diagnosis?

Answer
Splinter Haemorrhage

  • He underwent a transthoracic echocardiogram which revealed 10 × 4 mm mobile vegetation attached to the posterior leaflet of the mitral valve.
  • In infective endocarditis splinter hemorrhages are usually oriented in the distal third of the nail.
  • Other causes include minor trauma, atrial myxoma, and rheumatoid arthritis.

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