Question
A patient presented with low-grade and intermittent fever,Heart murmurs,petechiae over the body, Tender subcutaneous nodules on the distal pads of the digits and nontender maculae on the palms and soles.On fundoscopic examination,the following picture of Retina is seen.What is the most probable diagnosis?
A. CMV retinits
B. Hypertensive retinopathy
C. Diabetic retinoPathy
D. Bacterial endocarditis
Show Answer
|
Correct Answer » D
Explanation
|
|
Ans:D. Bacterial endocarditis
Retinal hemorrhages shown in the image are Roth’s spots
Roth’s spots
- They are retinal hemorrhages with white or pale centers.
- Composed of coagulated fibrin including platelets, focal ischemia, inflammatory infiltrate, infectious organisms, or neoplastic cells.
- They are usually caused by immune complex mediated vasculitis often resulting from bacterial endocarditis.
- Roth’s spots may be observed in leukemia, diabetes, subacute bacterial endocarditis, pernicious anemia, ischemic events, hypertensive retinopathy and rarely in HIV retinopathy.
Features of Infective Endocarditis
- Fever -low-grade and intermittent.
- Heart murmurs
- Petechiae
- Subungual (splinter) hemorrhages: Dark-red, linear lesions in the nail beds
- Osler nodes: Tender subcutaneous nodules usually found on the distal pads of the digits
- Janeway lesions: Nontender maculae on the palms and soles
- Roth spots: Retinal hemorrhages with small, clear centers
