35 years old male presented with road traffic accident. He suffered fracture of bilateral femur and was admitted to the hospital. While admitted for 3 days patient developed acute onset dysnea, fever and petechial rash in the chest region. Which of the following is the most probable diagnosis?
Correct Answer: Fat embolism
Description: Ans. is 'a' i.e., Fat embolism * Patient with long bone fracture who presents with acute onset shortness of breath with fever and petechial rash is most likely suffering from fat embolism.Fat Embolism* Fat embolism means circulation of fat globule away from its site of origin.* When fat embolism causes symptoms it is called fat embolism syndrome.Clinical manifestations of fat embolism* Clinical features are evident within 1-3 days. About 25 percent of patients develop symptoms within 12 hours and 75 percent within 36 hours. Occasionally the onset may be delayed for several days and some patients may go unnoticed initially. Early warning signs are a slight rise in temperature (pyrexia) and tachycardia.* The classical triad of fat embolism syndrome is:-i) Respiratory symptoms: Dyspnea, tachypnea, cyanosis, ARDS, low PO2.ii) Neurological symptoms: Confusion, disorientation, restlessness, irritation, delirium, convulsion, coma.iii) Petechial rash: In axilla, neck, periumblical area, conjunctiva of lower lid, retina, front & beck of chest, shoulder.
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