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.