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Funduscopy showed multiple Roth's spots (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). There was no infectious symptomatology or fever, but given the findings, a consultation was made with cardiology. The echocardiogram showed severe ventricular dysfunction secondary to probable unknown infective endocarditis on native bicuspid aortic valve, and severe aortic insufficiency. He was admitted with antibiotic therapy and positive serology was obtained for <span class="elsevierStyleItalic">Coxiella burnetii.</span> PET/CT showed increased metabolic activity surrounding the aortic valve. After abrupt worsening, the patient required urgent surgery, observing a severe calcification of bicuspid aortic valve with ring abscess and rupture of the noncoronary cusp. The valve PCR was positive for <span class="elsevierStyleItalic">C. burnetii.</span> Subsequent evolution was successful, with spontaneous improvement of visual disturbances.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Roth's spots are retinal hemorrhages with pale centers. They are easily identifiable by a direct ophthalmoscope and should make us think of a potential infectious endocarditis. They are not pathognomonic and may appear in leukemia, diabetes or hypertensive retinopathy and other diseases.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Ramos Suárez A, Fernández Gasso ML. Manchas de Roth y endocarditis infecciosa. Med Clin (Barc). 2019;152:e29.</p>" ] ] "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 740 "Ancho" => 950 "Tamanyo" => 53462 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015200000005/v1_201902230639/S2387020619300294/v1_201902230639/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015200000005/v1_201902230639/S2387020619300294/v1_201902230639/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020619300294?idApp=UINPBA00004N" ]
Journal Information
Vol. 152. Issue 5.
Pages e29 (March 2019)
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Vol. 152. Issue 5.
Pages e29 (March 2019)
Image in medicine
Roth's spots and infective endocarditis
Manchas de Roth y endocarditis infecciosa
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