Mrs. X had a femur fracture following A. On day 3, suddenly she developed tachypnea, dyspnea, and tachycardia and progressed to delirium and coma. Diagnosis is
Correct Answer: Fat embolism
Description: Microscopic fat globules can be found in the pulmonary vasculature after fractures of long bones or, rarely, in the setting of soft tissue trauma and burns. Fat embolism syndrome is the term applied to the minority of patients who become symptomatic. It is characterized by pulmonary insufficiency, neurologic symptoms, anemia, and thrombocytopenia, and is fatal in about 5% to 15% of cases. Typically, 1 to 3 days after injury there is a sudden onset of tachypnea, dyspnea, and tachycardia; irritability and restlessness can progress to delirium or coma.Ref: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 4; Hemodynamic Disorders, Thromboembolic Disease, and Shock; Page no: 128
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