Fat embolism syndrome, a condition characterized by hypoxia, bilateral pulmonary infiltrates, and mental status change.
Gurd’s and Wilson’s criteria
Major criteria
- Axillary or subconjunctival petechiae
- Hypoxaemia (PaO2 <60 mm Hg; FIO2 = 0.4)
- Central nervous system depression disproportionate to hypoxaemia
- Pulmonary oedema
Minor criteria
- Tachycardia >110 bpm
- Pyrexia >38.5 °C
- Emboli present in the retina on fundoscopy
- Fat present in urine
- A sudden inexplicable drop in haematocrit or platelet values
- Increasing ESR
- Fat globules present in the sputum
For the diagnosis of fat embolism syndrome, at least one major and four minor criteria must be present.
Schonfeld’s criteria
Score
- Petechiae (5 points)
- X-ray chest diffuse infiltrates (4 points)
- Hypoxemia (3 points)
- Fever (1 point)
- Tachycardia (1 point)
- Tachypnea (1 point)
- Confusion (1 point)
Score > 5 diagnosis FES
References:
- Akhtar S. Fat embolism. Anesthesiol Clin. 2009 Sep;27(3):533-50. [Medline]
- Glazer JL, Onion DK. Fat embolism syndrome in a surgical patient. J Am Board Fam Pract. 2001 Jul-Aug;14(4):310-3. [Medline]
- Gurd AR, Wilson RI. The fat embolism syndrome. J Bone Joint Surg Br. 1974 Aug;56B(3):408-16. [Medline]
- Liu S, Wu X, Zheng Y, Zhang A, Dai C, Pan L, Tu Q, Dai W, Tang W, Zhang H. Fat embolism syndrome: Never give up – A case report and literature review. Medicine (Baltimore). 2025 Aug 8;104(32):e43864. [Medline]
Created Oct 14, 2014.
Up-date Apr 08, 2026.
