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Fat embolism syndrome (FES) is a serious life-threatening manifestation of the fat embolism phenomenon characterized by Bergman’s triad of dyspnea, petechiae and mental confusion. While fat embolization into systemic circulation is common, FES occurs in a meagre 0.05%e3% of patients having isolated
long bone fractures. Though visual symptoms are commonly attributed to fat embolism retinopathy and
is a later occurrence, it may not always be the case. Cortical blindness has been seldom reported in
association with FES, and less so as a presenting complaint. Furthermore, no previous literature has
described the same in context of an isolated tibia fracture. We report a 20-year-old gentleman with an isolated right tibia shaft fracture who developed sudden onset diminution of vision in both eyes less than 24 h following trauma with no other complaints. Lack of any remarkable ophthalmoscopic findings or other symptoms left us with a diagnostic conundrum. He later went on to develop altered mentation, hypoxia and generalized tonic-clonic seizures with subsequent MRI revealing multiple cerebral fat emboli also involving both occipital lobes. Supportive measures were instituted and his general condition as well as vision gradually improved following which he underwent plate fixation of the fracture under spinal anaesthesia. The perioperative period was uneventful and he was discharged following staple removal. At one month of follow-up, the patient had no residual visual field defects or neurological deficits. Though FES is rare among isolated tibia fractures, this clinical catastrophe may strike in any unsuspected setting thereby warranting a high index of suspicion to ensure early diagnosis and improved patient outcomes. 相似文献
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Hamidreza Karimi-Sari Mohammad Ehsan Bayatpoor Maryam Aftabi Khotbesara Motahare Sadat Ebrahimi Zahra Sattari Paria Sattari Narges Saberi Shakib Hanie Taheri Sina Abdolrahim Poor Heravi Mahsa Dinizadeh Pedram Vahed Kiyana Shirsavar Hediye Hosseini Sara Rashvand Dorsa Jalaei Mahdi Azarafraz Mohebullah Naderi Mahtab Pourzakaria Seyed Moayed Alavian 《American journal of infection control》2017,45(11):e135-e141
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