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Bacterial Endocarditis: Roth Spots


These "white-centered" hemorrhages, originally described in patients with bacterial endocarditis, are not specific for that disease. They probably reflect microinfarcts, just like cotton wool spots, and occur in a litany of disorders, including essential hypertension, HIV, connective tissue disease, severe anemia, Behçet's disease, viremia, and hypercoagulable states.

They do not interfere with vision.

What to do?
While Roth spots are not specific for endocarditis, discovering them in a patient who has other suggestive features of endocarditis constitutes strong support for the diagnosis.

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