SHM Converge Scientific Abstract ePoster Gallery-A Case of Cerebral Fat Embolism Syndrome

Pdf Summary

This case describes a 32-year-old woman with HbSS sickle cell disease who developed acute encephalopathy during hospitalization after treatment for a diffuse urticarial rash. She initially presented with hypotension, tachycardia, fever, altered mental status, and abnormal chest imaging, then required intubation and ICU care. Laboratory findings suggested disseminated intravascular coagulation. Despite broad-spectrum antibiotics and supportive care, her condition worsened with seizures on hospital day 9, including status epilepticus. MRI of the brain showed ischemic changes and later diffuse supra- and infratentorial findings consistent with cerebral fat emboli.<br /><br />The authors highlight that fat embolism syndrome can occur in sickle cell disease when bone marrow infarction and necrosis release fat globules into the circulation. It may present with pain, rash, respiratory distress, and mental status changes, and can rapidly progress to multiorgan failure. In this case, management included red cell transfusions, antiepileptic therapy, ventilatory support, and prolonged ICU care. Her mental status gradually improved, and hemoglobin electrophoresis showed low hemoglobin S after transfusion.<br /><br />Her hospitalization was long and complex, ultimately requiring tracheostomy, which was later removed. After transfer back to hospital medicine, an individualized outpatient care plan helped guide pain control and rehabilitation. Physical and occupational therapy supported her recovery, and discharge planning focused on family support and coordination with outpatient teams. She was eventually discharged home on an oral pain regimen.<br /><br />The report emphasizes that cerebral fat embolism syndrome is rare but highly morbid and should be considered in sickle cell patients with altered mental status, because early recognition and coordinated transition of care are critical.

Asset Subtitle

Grace I. Ng

Meta Tag

Author List Francis W. Coyne, Grace I. Ng

Category Clinical Vignettes

Concept Fat Embolism Syndrome

Concept Acute Encephalopathy

Concept Cerebral Fat Embolism

Concept Sickle Cell Disease

Concept Altered Mental Status

Distinguished Non-Finalist

Presenter Organization University of Rochester Medical Center

Presenting Author Grace I. Ng

Track Adult

Keywords

sickle cell disease

cerebral fat embolism

acute encephalopathy

status epilepticus

disseminated intravascular coagulation

bone marrow infarction

red cell transfusion

intensive care unit

altered mental status

multiorgan failure

Fat Embolism Syndrome

Acute Encephalopathy

Cerebral Fat Embolism

Sickle Cell Disease

Altered Mental Status