Fat embolism

Fat embolism
Haematoxylin and eosin stain of a microscopic section of the lungs showing a blood vessel with fibrinoid material and an optical empty space indicative of the presence of lipid dissolved during the staining process.
Classification and external resources
Specialty	emergency medicine
ICD-10	O88.8, T79.1
ICD-9-CM	673.8, 958.1
DiseasesDB	4766
eMedicine	med/652
MeSH	D004620
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A fat embolism is a type of embolism in which the embolus consists of fatty material. They are often caused by physical trauma such as fracture of long bones, soft tissue trauma, and burns.

An asymptomatic latent period of about 12–48 hours precedes the clinical signs and symptoms. The severe form presents as acute pulmonary heart disease and respiratory failure. This may lead to death within a few hours of injury.

Clinical fat embolism syndrome presents with tachycardia, tachypnea, elevated temperature, hypoxemia, hypercapnia, thrombocytopenia, and occasionally mild neurological symptoms.

A petechial rash also called purpura that appears on the upper anterior portion of the body, including the chest, neck, upper arm, axilla, shoulder, oral mucosa and conjunctivae is considered to be a pathognomonic sign of Fat embolism syndrome (FES), however, it appears late and often disappears within hours. It results from occlusion of dermal capillaries by fat, and increased capillary fragility.

Central nervous system (CNS) signs, including a change in level of consciousness, are not uncommon. They are usually nonspecific and have the features of diffuse encephalopathy: acute confusion, stupor, coma, rigidity (neurology), or convulsions. Cerebral edema contributes to the neurologic deterioration.

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