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Definition:

Splinter hemorrhages are small areas of bleeding (hemorrhage) under the fingernails or toenails.



Alternative Names:

Fingernail hemorrhage



Considerations:

Splinter hemorrhages appear as narrow, red to reddish-brown lines of blood beneath the nails. They run in the direction of nail growth and are named splinter hemorrhages because they look like a splinter beneath the fingernail. The hemorrhages may be caused by tiny clots that damage the small capillaries under the nails.

Splinter hemorrhages are associated with infection of the heart valves (endocarditis ) and may be caused by vessel damage from swelling of the blood vessels (vasculitis ) or tiny clots that damage the small capillaries (microemboli).



Common Causes:
  • Trauma to the nail
  • Subacute or acute bacterial endocarditis


Home Care:

There is no specific care for splinter hemorrhages. Follow your health care provider's instructions for treating endocarditis.



Call your health care provider if:

Contact your health care provider if:

  • You notice splinter hemorrhages and you haven't had any recent trauma to the nail
Note: Splinter hemorrhages usually appear late in endocarditis. Likely other symptoms will cause you to visit your health care provider before splinter hemorrhages appear.

What to expect at your health care provider's office:

Your doctor will examine you to determine the cause of the splinter hemorrhages. Your doctor may ask you the following medical history questions:

  • When did you first notice this?
  • Have you had trauma to the nails recently?
  • Do you have a known diagnosis of endocarditis, or has your health care provider suspected endocarditis?
  • What other symptoms do you have, such as shortness of breath, fever, general ill feeling, or muscle aches?

Physical examination may include special attention to the heart and blood circulation systems.

Laboratory studies may include:

In addition, your health care provider may order:

After seeing your health care provider:

You may want to add a diagnosis related to splinter hemorrhages to your personal medical record.



References:

Seidel HM, Ball JW, Dains JE, Benedict GW. Mosby's Guide to Physical Examination. 6th ed. Mosby: Philadelphia, Pa; 2007.

Holzberg M. Common nail disorders. Dermatol Clin. 2006;24:349-354.




Review Date: 10/31/2007
Reviewed By: Robert Hurd, M.D., Professor of Endocrinology, Department of Biology, Xavier University, Cincinnati, Ohio, and physician in the Primary Care Clinic, Cincinnati Veterans Administration Medical Center, Cincinnati, Ohio. Review provided by VeriMed Healthcare Network.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
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