A 29-year-old woman underwent abdominal liposuction 13 days before her first visit to our hospital. Nine days later, she had fever and a painful erythema and swelling at the operation sites that rapidly became exacerbated and formed bullae the next day. On admission to the emergency room, she was suspected to have a pulmonary embolism. The abdominal lesion became necrotic and the laboratory findings revealed leukocytosis, elevated C-reactive protein, anemia, and a coagulation abnormality. Echocardiography and a pulmonary CT scan showed pulmonary artery dilatation without an overt thrombus, leading to a diagnosis of pulmonary embolism due to fat embolism. Septic shock was ruled out because of a negative bacterial culture result for the necrotic tissue obtained by surgical debridement. Despite the subsequent development of acute respiratory distress syndrome, she was successfully treated and survived. Fat embolism syndrome is a rare but serious complication after liposuction. Careful observation is needed after this procedure.
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