A 24-year-old man undergoes operative repair of a femoral shaft fracture following motor vehicle collision. On postoperative day 2, he develops acute dyspnea, confusion, and petechial rash on chest and axillae. Vital signs: BP 118/76, HR 118/min, RR 28/min, temp 38.2°C, SpO2 88% on room air. Laboratory studies show platelets 78,000/μL and elevated D-dimer. Chest X-ray shows normal parenchyma. Which diagnosis best explains this clinical presentation?
- A)Community acquired pneumonia
- B)Fat embolism syndromeGABARITO
- C)Spontaneous pneumothorax
- D)Acute respiratory distress syndrome
- E)Pulmonary embolism
Explicação
Fat embolism syndrome is correct. The triad of respiratory distress, neurologic symptoms, and petechial rash developing 1 to 3 days after long bone fracture is classic. Thrombocytopenia is common, and this differs from ordinary thromboembolic pulmonary embolis... Ver explicação completa e trilha adaptativa →