Janeway Lesions as a Manifestation of Aortic Graft Abscess

A 39-year-old man with history of intravenous drug use presented with fevers and back pain. Physical examination revealed multiple painless, small, hemorrhagic macules on the left plantar surface consistent with Janeway lesions. Janeway lesions were likely secondary to embolic sequelae of infected aortic graft without evidence of classical endocarditis, as vegetations were excluded on transesophageal echocardiogram.