Fat Embolism Syndrome

Case Synopsis

A 29-year-old man who has suffered fractures of the femur and tibia in a motorcycle accident is brought to the operating room for intramedullary nailing of both injuries. Surgery is unremarkable, but the patient is noted to have persistent tachycardia in the recovery room, despite adequate fluid resuscitation and pain control. The following morning, he is tachypneic and complains of significant shortness of breath. On examination, his pulse oximeter reading is 88% on room air, and he has a petechial rash on his chest and neck. A chest radiograph shows diffuse bilateral infiltrates.