40 years old patient with femur fracture with pulmonary infiltration and respiratory distress

Fat embolism Patient presenting long bone fractures + respiratory distress +petechiae / hemorrhage in brain suggests: fat embolism syndrome Generally associated with displaced long bone fractures of lower extremities Fat embolism will reach in the brain through a right to left cardiac shunt or through an intact pulmonary circulation in the patient without the shunt Major clinical characteristics: respiratory insufficiency, neurologic symptoms, and petechial skin rash