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A 24-year-old man presented with a three-day history of a blurred patch near the center of his left visual field. He reported no fatigue or weight loss. Ophthalmoscopy showed venous dilatation and multiple Roth's spots in both retinas (arrows in Panel A, showing the fundus of the left eye). Physical examination revealed splenomegaly extending to the right iliac fossa. No fever and no cardiac murmurs were noted. When blood was examined to measure the erythrocyte sedimentation rate, an elongated buffy-coat zone was observed (Panel B, bracket); a similar examination of blood from a healthy person is shown on the left. . . . [Full Text of this Article] |
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