A 32-year-old hospitalized man is evaluated for new-onset shortness of breath and confusion. The patient was admitted for a displaced femoral neck fracture of the left hip acquired after a fall the day before. He develops worsening shortness of breath and confusion and dies despite appropriate management. There are several scattered petechiae on the anterior chest wall. Microscopic evaluation of his pulmonary vessels reveals the findings shown below. Which of the following most likely predisposed this patient to developing the observed histopathologic abnormality?

Question

A 32-year-old hospitalized man is evaluated for new-onset shortness of breath and confusion.  The patient was admitted for a displaced femoral neck fracture of the left hip acquired after a fall the day before. He develops worsening shortness of breath and confusion and dies despite appropriate management. There are several scattered petechiae on the anterior chest wall. Microscopic evaluation of his pulmonary vessels reveals the findings shown below.  Which of the following most likely predisposed this patient to developing the observed histopathologic abnormality?

Quizplus · Accepted Answer

Eductional Objective: Fat embolism syndrome most commonly results from the release of fat globules from bone marrow following a long-bone or pelvic fracture.  The fat globules form inflammatory aggregates that cause microvessel obstruction and systemic inflammation leading to the triad of respiratory distress, neurologic dysfunction, and petechial rash.

A 32-Year-Old Hospitalized Man Is Evaluated for New-Onset Shortness of Breath