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DOI 10.1097/ms9.0000000000002133

Медицинская библиотека · Annals of medicine and surgery (2012) · 2024

Clinical diagnosis of fat embolism syndrome with septic shock following polytrauma: a case report.

Shahi Anil, Niraula Biraj, Santyan Bir B, Kafle Nischal, Gaud Shivendra K, Gosain Dinesh, Gupta Manish, Kharel Avash, Khatri Mala

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Аннотация

INTRODUCTION AND

IMPORTANCE

Fat embolism syndrome (FES) arises from the systemic effects of fat emboli in microcirculation. While sepsis is characterized by pathological, physiological, and metabolic abnormalities caused by infection. Septic shock is identified by elevated blood lactate (>2 mmol/l) and the need for vasopressors to maintain a mean arterial pressure of 65 mmHg or higher in the absence of hypovolemia.

CASE PRESENTATION: This case report discusses the clinical course and treatment of a 50-year-old male involved in a road traffic accident resulting in polytrauma. The patient presented with multiple fractures, hemopneumothorax, lung contusions, and rib fractures. He was then stabilized following which fractures were reduced and managed operatively. Postoperatively, the patient developed FES with septic shock, manifested by altered consciousness, petechial rashes, and respiratory distress. He was managed with intubation, chest drainage, and a combination of antibiotics, anticoagulants, and vasoactive agents. A tracheostomy was performed due to respiratory insufficiency. Following 29 days in the SICU, the patient's condition was stabilized and shifted to the general ward for further management. He was discharged after 48 days, with a complete recovery and a 2-week follow-up. This case report depicts the challenges in the management of FES with septic shock following polytrauma.

CONCLUSION

This case report is a comprehensive overview of FES complicated with septic shock. It highlights the importance of supportive care as the primary treatment modality, incorporating various medical interventions. The successful outcome and complete recovery of the patient underline the significance of prolonged monitoring, wound care, and physiotherapy.

Для цитирования: Shahi Anil, Niraula Biraj, Santyan Bir B, Kafle Nischal, Gaud Shivendra K, Gosain Dinesh, Gupta Manish, Kharel Avash, Khatri Mala. Clinical diagnosis of fat embolism syndrome with septic shock following polytrauma: a case report.. Annals of medicine and surgery (2012). 2024. DOI: 10.1097/ms9.0000000000002133.
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