Anything else here pointing to Fat Embolism Syndrome other than the long bone fracture? Is "fluffy infiltrates" pathognomonic for FES? Why could it not also be ARDS?
hambonetwo things:
1) petechial hemorrhages
2) will see respiratory alkalosis in fat embolism, and metabolic acidosis in ARDS+1
komodoi was also torn on this one because their PaO2/FiO2 is low (267), which I think technically qualifies as ARDS, especially with the fluffy infiltrates. I think the petechiae is the main thing that points to fat embolism over ARDS+
spiroskeetAlso worth keeping in mind that, according to UWorld, the petechial rash doesn't necessarily always present in fat embolism syndrome. However, if it does present along with the rest of the clinical picture, it's a dead ringer for FES.+
I have been waiting my entire medical career to finally get a question on fat embolism syndrome. I always pray for it every time I see a big fracture, but it never delivers.
Key idea: Fat embolism often develops 24 to 72 hours after inciting event (long-bone fracture, orthopedic surgery, etc.)
Key idea: Fat embolism is a clinical diagnosis that leads to triad of (1) Respiratory distress (2) Neurologic dysfunction (3) Petechial rash (or thrombocytopenia)
submitted by ∗russnels(20)
Anything else here pointing to Fat Embolism Syndrome other than the long bone fracture? Is "fluffy infiltrates" pathognomonic for FES? Why could it not also be ARDS?