Open AccessFat Embolism Syndrome - Diagnostic Dilemma During Covid-19 Pandemic
Author(s) -
Nimisha Mahesh Parkar,
Frida Gomes,
Prabhav Pramod Dessai,
Chandia Rose Mendes,
Priyanka Suresh Phadte
Publication year - 2022
Publication title -
journal of evolution of medical and dental sciences
Language(s) - English
Resource type - Journals
eISSN - 2278-4802
pISSN - 2278-4748
DOI - 10.14260/jemds/2022/59
Subject(s) - medicine , fat embolism , fat embolism syndrome , intramedullary rod , pulmonary embolism , subclinical infection , embolism , intensive care medicine , pediatrics , surgery
Acute onset of breathlessness and type 1 respiratory failure in young patients in the orthopaedic ward with traumatic pelvic or long bone fractures often raise suspicion of thromboembolic event, classic fat embolism and fat embolism syndrome (FES). However, in the era of the prevailing pandemic, the clinical presentation may cause suspicion of Covid-19 infection, creating a dilemma for diagnostic purposes, causing inadvertent delays in definitive management. Although clinically significant in 30 % of cases, FES in subclinical form is believed to be occurring in a large percentage of patients with long bone and pelvic fractures, secondary to a rise in intramedullary pressure and venous sinusoidal disruption. Debris of bone and fat gain access to the systemic and pulmonary circulation cause mechanical obstruction as well as multi-organ dysfunction syndrome. FES can be recognised by classic Bergman’s triad1 characterised by hypoxaemia, petechial rash and mental changes. We present a case of fat embolism syndrome that was reported in a tertiary care centre during the peak of the Covid19 pandemic.