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Roth's spots as an only sign of acute myeloid leukemia.

A 26 years male presented to us with intermittent low grade fever for 1 month. The fever had three or four peaks per day and the maximum temperature documented in the period so far was 101.40 F. It subsided after antipyretic use and was associated with generalized weakness for the same duration. No specific history was elicited suggesting involvement of any other organ systems. Notably, the patient didn’t have any bleeding episodes, cough or altered bowel habits. He was a farmer and had no known addiction to tobacco or alcohol. The patient denied high-risk sexual behaviour or close contact with any known cases of tuberculosis. General examination revealed elevated temperature (101.20F), mild pallor without any evidences of mucosal bleeding or oropharyngeal candidiasis. However, he had prominent gum hypertrophy (Fig. 1) with enlarged tonsils. No sternal tenderness, lymphadenopathy or visceromegaly could be documented. On direct ophthalmoscopy we found multiple Fig. 1 : Gum hypertrophy