Bilateral Roth Spot in the Setting of Mitral Valve Endocarditis

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    • By Helder Vasconcelos
      FMABC
      Co-author(s): Lovily Paiva; Evelyn Alvernaz; Eliana Oliveira, Nicolas Oleinik; Amanda Castro; Jemima Kretli.
    • Uploaded on Aug 18, 2025.
    • Last modified by Joshua Friedman on Aug 19, 2025.
    Rating
    Appears in
    Miscellaneous
    Condition/keywords
    Roth Spots, Infectious endocarditis
    Photographer
    Helder Vasconcelos
    Imaging device
    Smartphone Fundoscopy
    Description
    A 55-year-old man with chronic alcoholism presented with wasting and fever. The symptoms were preceded by a recent tooth extraction and gingivitis. Fundus examination in the ICU showed a retinal hemorrhage with a white spot (Roth spot) associated with peripapillary hemorrhage and cotton wool exudate. A similar Roth spot was observed in the contralateral eye.

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