Medicina pulmonar y respiratoria

A Fat Embolism Case with Fat Globules on Retinal Examination

Abstract

Eyüp Sabri Uçan, Ali Osman Saatçi, Onur Turan, Önder Limon and Tuba Gümüs

Fat embolism, which is an important type of non-trombotic embolism, is generally seen as a complication of long bone trauma. It presents with respiratory, circulatory, neurologicalsystem symptoms. This multisystemic diseases may end with mortality. A 27-year-old man referred to our hospital with confusion, dyspneaand fever. His complaints started after a long leg cast applied because of a right tibia fracture 36 hours ago. Chest radiographshowed bilateral reticulonodular densities His arterialbloodgases measurement revealed hypoxemiaand hypocapnia. There was no pulmonary embolismshown in thorax CT angiography, as demonstrating bilateral diffuse infiltrations. Fat embolism was thought in differential diagnosis with a clinical presentation of acute respiratory disease syndrome (ARDS). The ophthalmologistsfound out characteristic fat globules on retinal examination. Intravenous glucocorticoid, oxygen and supportive treatment were administered for the patient. Clinical improvement was observed during follow-up, as his symptoms and radiological findings regressed. Our case revealed respiratory insufficiency (one major criteria), high fever, retinal signs, oliguria and tachycardia (four minor criteria), and high sedimentation rate (one laboratory finding), which met the criteria for FES. We want to present our fat embolism case with characteristic properties of this rarely seen disease with characteristic fat globules on retinal examination.