Fat Embolism Syndrome Treated with Methylprednisolone

A 74-year-old woman presented with sudden dyspnea 22 h after orthopedic surgery. Echocardiography revealed significant right ventricular dilatation, suggesting the development of acute pulmonary embolism. However, contrast computed tomography showed no signs of pulmonary thromboembolism, leading to suspicion of fat embolism syndrome (FES). Despite the administration of high-dose norepinephrine and dobutamine, her hemodynamic status did not improve, and high-dose methylprednisolone (250 mg) was administered. After administration, her hemodynamic status improved promptly, and she soon showed normotension. The current case suggests the possibility of high-dose methylprednisolone for hemodynamic improvement in FES.