A 20-year-old male patient is admitted to the emergency department following a high-impact motor vehicle accident. He exhibits sudden onset of dyspnea, tachypnea, and confusion a few hours post-admission. He was previously diagnosed with multiple long bone fractures. Which of the following is the most likely diagnosis?
The symptoms of dyspnea, tachypnea, and confusion, occurring a few hours after a trauma that resulted in multiple long bone fractures, suggest a fat embolus syndrome. This condition arises when embolic fat macroglobules pass into the bloodstream, often from marrow fat, which can occur after trauma to long bones. It is a life-threatening emergency requiring prompt recognition and treatment. Pulmonary embolism, while it presents with similar pulmonary symptoms, would not typically include neurological symptoms like confusion unless it leads to hypoxemia. Systemic infection and acute respiratory distress syndrome (ARDS) are less likely based on the immediate post-injury timing and specific symptom combination.
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Musculoskeletal and Wound Emergencies
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