A 32-year-old woman develops fat embolism syndrome 48 hours after a femoral shaft fracture. Which triad of clinical findings is classic for fat embolism syndrome?
- A Fever, altered consciousness, and progressive respiratory failure with petechial rash ✓
- B Hypoxia, thrombocytopenia, and petechial rash on the chest and conjunctivae
- C Tachycardia, hypertension, and lactic acidosis
- D Pulmonary embolism, DVT, and sudden cardiac arrest
Correct answer: A. Fever, altered consciousness, and progressive respiratory failure with petechial rash
Explanation
The Gurd and Wilson criteria for fat embolism syndrome include major criteria (respiratory insufficiency, cerebral involvement, petechial rash) and minor criteria (fever, tachycardia, retinal fat emboli, renal changes, jaundice, thrombocytopenia, fat macroglobulinaemia). The classic clinical triad consists of the three major features: progressive respiratory failure (ARDS-like hypoxia), altered consciousness/cerebral dysfunction, and petechial rash over the upper trunk, axillae and conjunctivae — typically appearing 24–72 hours after long bone fracture.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
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