Chest Imaging Case Atlas by Parker Mark S. & Rosado-de-Christenson Melissa L. & Abbott Gerald F

Author:Parker, Mark S. & Rosado-de-Christenson, Melissa L. & Abbott, Gerald F. [Parker, Mark S.]
Language: eng
Format: epub
Publisher: Thieme New York
Published: 2012-04-29T21:00:00+00:00

Etiology

In addition to the clinical scenarios outlined above, FES has been described following total joint arthroplasty, external cardiac massage, spontaneous vertebral body compression fractures, and bone biopsy, and with acute sickle cell crisis.

Clinical Findings

Symptoms usually occur one to three days after the injury and may include hypoxia (96%); mental status changes (59%); petechial skin rash (33%); fever with temperature higher than 39°C (70%); tachycardia (heart rate >120 beats per minute) (93%); thrombocytopenia (platelet count <150 × 109/L) (37%); and unexplained anemia (67%). Only the petechial skin rash was absent in this particular patient. However, both the BAL fluid and urine analysis were markedly positive for lipid-laden macrophages. A contrast-enhanced CT for pulmonary embolism performed two days later revealed extensive pulmonary emboli throughout the left lung. It was postulated the pulmonary emboli may have “protected” the left lung from sequelae of the fat and MMPA cement emboli and resultant ARDS.

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