title: Cotton-wool spots as a sign in leptospirosis (Weil's disease).
abstract: A 44-year-old black male presented with fever, myalgia and weakness. He had elevated blood urea nitrogen, creatine phosphokinase and serum glutamic-oxaloacetic transaminase. During the first 6 days of this undiagnosed illness azotemia increased, a pericardial friction rub occurred, and hematuria was present. On the 7th day bilateral subconjunctival hemorrhages, anterior uveitis, and peripapillary cotton-wool spots were noted. This combination of findings suggested leptospirosis, which was subsequently confirmed by specific antibody titers. Therapeutic response was achieved with high-dose systemic steroids.
mesh_terms: D000328:Adult; D003229:Conjunctival Diseases / Q000175:diagnosis / Q000209:etiology; D003937:Diagnosis, Differential; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007921:Leptospira interrogans / Q000302:isolation & purification; D008297:Male; D012164:Retinal Diseases / Q000175:diagnosis / Q000209:etiology*; D014605:Uveitis / Q000175:diagnosis / Q000209:etiology; D014895:Weil Disease / Q000150:complications / Q000175:diagnosis*