A 24-year-old man undergoes repair of a femoral shaft fracture after a motor vehicle collision. Two days postoperatively, he develops acute dyspnea, confusion, and a petechial rash over the upper chest and shoulders. Vital signs show BP 110/68 mmHg, HR 118 bpm, RR 28/min, temperature 38.2°C, and SpO2 88% on room air. Chest X-ray reveals bilateral diffuse alveolar infiltrates. Platelet count is 95,000/μL. He denies recent leg swelling. Which of the following is the most likely diagnosis?
- A)Aspirational pneumonitis
- B)Fat embolism syndromeGABARITO
- C)Tension pneumothorax
- D)Amniotic fluid embolism
- E)Septic pulmonary emboli
Explicação
Fat embolism syndrome classically occurs 1 to 3 days after long bone fracture or orthopedic surgery. The triad of hypoxemia, neurologic symptoms, and petechial rash is highly characteristic. Fat globules trigger inflammatory injury in the pulmonary vasculature... Ver explicação completa e trilha adaptativa →