Fat embolism syndrome: Never give up – A case report and literature review

Rationale: Fat embolism syndrome (FES) is a complex syndrome with high in-hospital mortality and the diagnosis and treatment of FES remain challenging. In this article, we present a case report as well as a comprehensive review of trauma-related cases to enhance the understanding of FES. Patient concerns: An 18-year-old young man developed a fever, tachycardia, and dyspnea about 58 hours after the trauma. Chest computed tomography (CT) scan revealed blizzard-like changes on lung window obviously different from the initial chest CT. Diagnoses: The patient’s medical history, clinical manifestations, and auxiliary examination results, especially the bronchoalveolar lavage fluid confirmed the diagnosis. Interventions: Chest CT scan demonstrated a significant absorption of the original lesions after the completion of methylprednisolone therapy for 3 days. Outcomes: The patient was successfully discharged from the hospital without any complication. Lessons: When sudden dyspnea or altered consciousness arises, the possibility of FES should be taken into account. The bronchoalveolar lavage fluid can be helpful in diagnosing and assessing the severity of pulmonary embolism. Methylprednisolone can be employed in the treatment of FES while the complications should be considered.