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Peripheral blood smear – An expeditious test in the preliminary diagnosis of bone marrow embolism in a case of multiple fractures: A case report
Rajalakshmi B Rajashekar1, S Suchitha1, Mahesh S Shetty2, Apoorva P Gowda1
1 Department of Pathology, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
2 Department of Surgical Gastroenterology, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
Correspondence Address:
Rajalakshmi B Rajashekar,
Rajashekar, Department of Pathology, JSS Medical College, JSS Academy of Higher education and Research, Mysuru, Karnataka
India
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/ijpm.ijpm_394_21
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Bone marrow embolism is known to occur after fractures of long bones such as the femur and pelvis. We report a case of multiple fractures in a 32-year-old female patient, demonstrating bone marrow elements in the peripheral blood as early as 2 hours after trauma. This is the first case being reported with an ante-mortem demonstration of circulating marrow emboli in the peripheral blood, while the previously reported cases have demonstrated the emboli in post-mortem examination. A careful correlation of the clinical history of trauma, hematology auto-analyzer results, and the presence of bone marrow particles and fat globules in peripheral blood helped in arriving at the diagnosis of fat embolism in our case irrefutably.
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