Tuberc Respir Dis.  2006 Dec;61(6):562-566. 10.4046/trd.2006.61.6.562.

A Case of Fat Embolism Syndrome of Fat Globules Found in BAL Fluid after Recovery from Acute Respiratory Failure

• Park SR
• Kim HS
• Lee JH
• Kim SH
• Kim TH
• Yoon HJ
• Park SS
• Shin DH
• Park CK

• KMID: 1970241
• DOI: http://doi.org/10.4046/trd.2006.61.6.562

Abstract

Fat embolism syndrome is a rare clinical diagnosis of dyspnea with acute respiratory failure and neurological signs caused by a traumatic long bone fracture. We report a case of fat embolism in a 22 year-old man after a traffic accident. Dyspnea and stuporous mental changes developed on the 1st day after the external fixation operation of a left metaphyseal femur fracture. On the following day, he was transferred from a hospital to this one because of acute respiratory failure. After recovery, macrophages with fat droplets were found in the bronchoalveolar lavage fluid 1. It is important to diagnose a fat embolism as the correct cause of acute respiratory failure through the BAL in the acute state of fat embolism syndrome It is believed that clinically apparent or sometimes hidden fat embolism syndrome can be diagnosed from the BAL during the recovery state.

Keyword

Fat embolism syndrome; Bronchoalveolar lavage; Fat globules; Acute respiratory failure

MeSH Terms

Accidents, Traffic
Bronchoalveolar Lavage
Bronchoalveolar Lavage Fluid
Diagnosis
Dyspnea
Embolism, Fat*
Femur
Fractures, Bone
Humans
Macrophages
Respiratory Insufficiency*
Stupor
Young Adult

Figure

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  Figure 1 (A) Chest AP shows no active lesion on trauma day. (B) On 4th day after trauma, diffuse bilateral infiltrations with ground glass opacities and consolidation were developed.

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  Figure 2 Chest CT shows bilateral diffuse consolidations with ground glass opacities predominantly on dependant portions.

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  Figure 3 On 3rd day after trauma, brain MRI shows multiple foci of high signal intensity in the bilateral cerebral hemispheres, deep and subcortical white matters, and corpus callosi.

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  Figure 4 On the 13th hospital day, analysis of BAL fluid revealed fat-containing (lipid-laden) macrophages (oil red O stain, ×1000)

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