Roth’s spots (named for Moritz Roth, Swiss physician, 1849–1914) are traditionally considered a manifestation of subacute bacterial endocarditis. However, the differential diagnosis of retinal hemorrhages with a central white spot, also referred to as a hemorrhagic cotton-wool spot, includes such entities as anemia, leukemia, retinal phlebitis, Candida albicans infection, vascular diseases, collagen diseases, bacterial sepsis, viral pneumonia, and kala azar, just to name a few, as shown in the figures.1
Which is the subacute endocarditis–related “true” Roth spot?
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
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- Copyright © 1999 by American Heart Association
Roy FH. Ocular Differential Diagnosis. 5th ed. Philadelphia, Pa: Lea & Febiger; 1993:548–549.