Conclusions:
In summary, a high index of suspicion is required to diagnose FES, especially in long bone and pelvic fractures, which are clinically not apparent. CFE should be considered when patients have long bone and pelvic fractures, multiple bone fractures, or deteriorated neurological status. Our case highlights the delayed systemic manifestations of FES and early neurological manifestations that mimic many other diseases like stroke and meningitis. Patients without an intracardiac shunt may also suffer CFE. Additionally, the treating physician should be cautious in excluding pulmonary embolism, which presents similarly but has a different management line. CFE patients may recover completely with appropriate treatment.