Roth's spot is seen in?

ANSWER: (A) Infective endocarditisREF: Harrison's Principles of Internal Medicine 17th ed-chapter 118"Roth spots are flame shaped hemorrhages with central cotton wool spots. They are caused by immune complex deposition and are seen in subacute bacterial endocarditis""In the case of leukemia, the Roth spot is composed of a hemorrhage with a central aggregation of white blood cells"Feature of infective endocarditis:Fever Chills and sweatsAnorexia, Weight loss, Malaise, Myalgias, arthralgias, Back painHeart murmur, New/worsened regurgitant murmurArterial emboliSplenomegalyClubbingPeripheral manifestations (Osier s nodes, subungual hemorrhages, Janeway lesions, Roth's spots)PetechiaeLaboratory7 manifestations: Anemia, Leukocytosis, Microscopic hematuria, Elevated erythrocyte sedimentation rate >90, Elevated C-reactive protein level >90, Rheumatoid factor, Circulating immune complexes, Decreased serum complementCauses of Roth spots:Subacute bacterial endocarditisAcute leukemiaPernicious anemiaScurvyCO poisoningPost cardiac bypass surgery