Asphyxiating intra-alveolar haemorrhage: rare form of fat embolism syndrome.

We report a case of a 23-year-old patient admitted for a right femur fractu re resulting from a traffic accident. An intra-alveolar haemorrhage occurre d 48 hours later, with asphyxia anaemia, haematic bronchial aspirations, an d bilateral alveolar opacities at chest X-ray. This symptomatology was asso ciated with fever, sub-conjunctival petechiae, major hypocholesterolemia, d eterioration of renal function, and cholestasis. All these features suggest ed a fat embolism. Other possible aetiologies were discarded because of nor mal cardiovascular and immunologic systems and absence of infection. The ou tcome under symptomatic treatment was satisfactory within 15 days. The occu rrence of intra-alveolar haemorrhage in post-traumatic fat embolism is a ra re event caused by pulmonary capillary obstruction by fat emboli. (C) 1998 Elsevier, Paris.