These skin changes include petechiae, splinter hemorrhages on the nail beds, and Janeway lesions which are nonpainful hemorrhagic lesions on the palms and soles. Other clinical manifestations may include cardiac murmur, sepsis, Osler nodes (painful, red nodules on the fingers and toes), weight loss, fever, back pain, night sweats, and arterial emboli which impair circulation to any number of organs