Roth spots are seen in:
Ans: A (Infective endocarditis) Ref; Harrisons Principles of Internal Medicine 18th edition ROTH SPOTS in Infective Endocarditis They are retinal hemorrhages with pale centres. They represent capillary hemorrhages and not bacterial infection. Apart from IE, they can also be seen in vasculitis, anemia, leukemia, diabetes and carbon monoxide poisoning. Explanation: Roth's spots are retinal hemorrhages with w hite or pale centers composed of coagulated fibrin. They are typically seen using an ophthalmoscope or slit lamp exam. They are usually caused by immune complex mediated vasculitis often resulting from bacterial endocarditis. Roth's spots may also be seen in Leukemia Diabetes Subacute bacterial endocarditis Pernicious anemia Ischemic events HIV retinopathy Manifestations of Infective Endocarditis HISTORY Prior congenital or rheumatic heart disease Preceding dental, urinary tract, or intestinal procedure Intravenous drug use Central venous catheter Prosthetic heart valve SYMPTOMS Fever Chills Chest and abdominal pain Arthralgia, myalgia Dyspnea Malaise, weakness Night sweats Weight loss CNS manifestations (stroke, seizures, headache) SIGNS Elevated temperature Tachycardia Embolic phenomena (Roth spots, petechiae, splinter nail bed hemorrhages, Osier nodes, CNS or ocular lesions) Janeway lesions (painless small erythematous or hemorrhagic lesions on the palms and soles) New or changing murmur Splenomegaly Arthritis Heart failure Arrhythmias Metastatic infection (arthritis, meningitis, mycotic arterial aneurysm, pericarditis, abscesses, septic pulmonary emboli) Clubbing LABORATORY Positive blood culture Elevated erythrocyte sedimentation rate Elevated C-reactive protein Anemia Leukocytosis Hypergammaglobulinemia Hypocomplementemia Cryoglobulinemia Rheumatoid factor Hematuria Renal failure: azotemia, high creatinine (glomerulonephritis) Chest radiograph: bilateral infiltrates, nodules, pleural effusions Echocardiographic evidence of valve vegetations, prosthetic valve dysfunction or leak, myocardial abscess, new-onset valve insufficiency
Infective endocarditis
Central retinal vein occlusion
Retintits pigmentosa
Diabetic retinopathy