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October 1962

Petechiae Associated with Systemic Fat Embolism

Author Affiliations


Resident in Dermatology (Dr. Stephens); Instructor in Medicine (Dr. Fred).

From the Departments of Dermatology and Internal Medicine, the Jefferson Davis Hospital and the Baylor University College of Medicine.

Arch Dermatol. 1962;86(4):515-517. doi:10.1001/archderm.1962.01590100129023

In patients with recent fracture of the long bones, the sudden appearance of petechiae over the upper part of the body may be indicative of systemic fat embolism. The purpose of this report is to describe a case with the clinical features of post-traumatic systemic fat embolism and to emphasize the diagnostic significance of petechiae in this disorder.

Report of Case  A 25-year-old Latin-American woman was hit by a car and sustained a closed fracture of the right femur. Thirty hours later, she suddenly developed shaking chills, confusion, lethargy, tachycardia, tachypnea, and a temperature of 103 F. Multiple petechiae were noted in the palpebral and bulbar conjunctivae of both eyes (Fig. 1). Similar lesions were present over the arms (Fig. 2), shoulders, and anterolateral portions of the neck and thorax. These findings were thought to result from systemic fat embolism. Routine examinations of the blood and spinal fluid were performed