Splinter Haemorrhage

Dr. A. Nagarajan*

Department of Pulmonology, Kauvery Hospital, Cantonment, Trichy

Correspondence: nagapulmo@gmail.com


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.


What is your diagnosis?

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.

From the editor

Our question to post graduate residents is this:

If you see this, where else you would you look to find a famous “named” sign?