Fat embolism syndrome mimicking Covid-19 infection with concomitant Purtscher’s retinopathy

Abstract

Fat embolism syndrome (FES) is a multiple organ disorder that can appear after long bone fractures. The clinical picture includes hypoxia predominantly, accompanied by diffuse petechiae, alveolar infiltrates, altered mental status, fever, tachypnea, and tachycardia. We present a case of FES in a 35-year-old man with no prior medical history, following fracture of neck of right femur. Fifteen hours post-admission, patient developed respiratory failure with altered mental status and needed admission in the intensive care unit. The chest radiography and later chest tomography raised the suspicion of a COVID-19 disease, even if our first suspicion was FES. After being carefully investigated for COVID-19 with two negative RT-PCR SARS-CoV-2 tests, patient received treatment for FES. In the context of the SARS CoV-2 pandemic, differential diagnosis has become an increasingly challenging process.