A 23-year-old man is hospitalized for a femoral shaft fracture from a motorcycle collision. Thirty-six hours later, he develops acute dyspnea, confusion, and a petechial rash over the chest and axillae. Vital signs show BP 110/68 mmHg, HR 118/min, RR 28/min, temperature 38.2°C, and SpO2 89% on room air. Chest X-ray reveals bilateral interstitial infiltrates. Platelet count is 95,000/μL. He denies leg swelling. Which of the following is the most likely diagnosis?
- A)Primary spontaneous pneumothorax
- B)Air embolism from decompression sickness
- C)Fat embolism syndromeGABARITO
- D)Septic emboli from endocarditis
- E)Amniotic fluid embolism
Explicação
Fat embolism syndrome is correct. Long bone fracture followed by hypoxemia, neurologic symptoms, and petechiae within 1 to 3 days is the classic triad. Fat globules enter the bloodstream and trigger mechanical obstruction and inflammatory injury in the pulmona... Ver explicação completa e trilha adaptativa →