Diffuse Alveolar Hemorrhage: A Rare and Life-Threatening Manifestation of Fat Embolism Syndrome

Fat embolism syndrome (FES) often occurs following a long bone fracture and typically manifests within 24–72 h as respiratory distress, petechiae, and neurological signs. Fat embolism associated diffuse alveolar hemorrhage (DAH) is a rare but potentially life-threatening pulmonary complication. Here, we present a case of a 22-year-old male with femur and mandibular fractures following trauma who developed progressive hypoxemia and hemoptysis on day 2 of trauma. Chest X-ray imaging revealed bilateral alveolar infiltrates, and bronchoscopy confirmed alveolar hemorrhage. The patient was placed on mechanical ventilation due to severe alveolar hemorrhage. Treatment was initiated with methylprednisolone, along with nebulization of adrenaline and tranexamic acid to control the bleeding. DAH secondary to FES should be suspected in trauma patients presenting with hemoptysis and hypoxemia. Early diagnosis and prompt administration of corticosteroids and antifibrinolytic therapy can significantly improve patient outcomes.