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.