title: A forgotten clinical sign making a comeback.
abstract: We report a case of Staphylococcus aureus infective endocarditis in a patient presenting with fever and rare cutaneous manifestations of Osler Nodes and Janeway Lesions. There had not been any distinct risk factors. His echocardiography subsequently revealed vegetation at the anterior mitral valve leaflet. As Staphylococcus aureus infective endocarditis is of utmost significance in morbidity and mortality, a sharp clinical acumen and follow up investigations is required alongside a prolonged course of antibiotics. Our patient was then started on intravenous cloxacillin for 28 days and gentamicin for 5 days to which he made good progress and recovery.
authors.affiliation: Clinical Specialist, Infectious Disease, Internal Medicine, Hospital Sultanah Bahiyah Alor Setar, KM 6, Jalan Langgar, Alor Setar, Kedah Darul Aman 05460, Malaysia. symeon_chiam@yahoo.co.uk.
authors.forename: K H
authors.initials: KH
authors.lastname: Chiam
authors.affiliation: Clinical Specialist, Infectious Disease, Internal Medicine, Hospital Sultanah Bahiyah Alor Setar, KM 6, Jalan Langgar, Alor Setar, Kedah Darul Aman 05460, Malaysia.
authors.forename: C T
authors.initials: CT
authors.lastname: A Hing
authors.affiliation: Clinical Specialist, Infectious Disease, Internal Medicine, Hospital Sultanah Bahiyah Alor Setar, KM 6, Jalan Langgar, Alor Setar, Kedah Darul Aman 05460, Malaysia.
authors.forename: L L
authors.initials: LL
authors.lastname: Low