Pulmonary Fat Embolism Syndrome: A Case Report and Literature Review

Fat embolism syndrome (FES) is caused by a systemic inflammatory response arising from embolized fat particles that block blood vessels and disrupt blood supply, particularly in the respiratory microcirculation. Despite its high morbidity and mortality, FES is still challenging to diagnose due to its versatile symptoms.

In this article, we describe case reports of two patients with pulmonary FES from Zhongnan Hospital of Wuhan University, Wuhan, China. The two patients were diagnosed based on their detailed medical histories, such as a history of liposuction surgery, low oxygen saturation, dyspnea, and chest computed tomography (CT). Both of them received continuous oxygen inhalation therapy and antibiotic treatment. The first patient received additional anti-inflammation and anticoagulation treatment. The symptoms and CT improved after treatments. They were discharged and completely cured. Literature Review: We obtained and analyzed the clinical manifestations, treatments, and prognosis data of 206 patients diagnosed with pulmonary FES between January 1900 and July 2021 from the China National Knowledge Infrastructure database.

The analysis of our two cases and the literature review suggest that patients with symptoms (such as respiratory system symptoms, nervous system symptoms, cardiovascular system symptoms, and mucocutaneous bleeding) combined with a history of fracture and other risk factors should be considered pulmonary FES cases. Furthermore, respiratory support and glucocorticoid treatment may be effective in preventing the death of pulmonary FES patients.