Clinical Manifestations: Low grade fever, heart murmur, arthralgia, myalgias, back pain, abdominal discomfort, wt. loss, headache, and clubbing of fingers, petechiae, small, painful nodules (Osler nodes) may be present in pads of fingers or toes,Irregular, red or purple, painless flat macules (Janeway lesions) may be present on palms, fingers, hands, soles, and toes, embolization to the brain may cause neurologic damage, and splinter hemorrhages (i.e., reddish-brown lines and streaks) may be seen under the proximal half of fingernails and toenails.