THE ASSOCIATION of petechial hemorrhages with fat embolism was first noted by Benestad1 in 1911. These petechial hemorrhages are the classic physical finding which firmly establishes the diagnosis of fat embolism.2 They appear in crops anytime during the first week after injury, occurring in the axillae, across the chest and the base of the neck, and extending down the flanks into the thighs. Subconjunctival and submucous petechiae are also seen occasionally. Therefore, the appearance of petechial hemorrhages is an indication of fat embolism. Sevitt3 found fat emboli in the superficial dermal capillaries in biopsy specimens of the skin about the petechiae. We have been unable to confirm this finding after examination of serial sections of skin specimens from patients having fat embolism with petechiae. Platelet counts in some of our patients who have fat embolism and spontaneous petechial hemorrhages have been very low. It is our present
Garner JH, Peltier LF. Fat EmbolismThe Significance of Provoked Petechiae. JAMA. 1967;200(6):556–557. doi:10.1001/jama.1967.03120190182037
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