{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T23:25:34Z","timestamp":1783034734238,"version":"3.54.6"},"reference-count":45,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:00:00Z","timestamp":1756339200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Fat embolism frequently occurs as a result of trauma, such as long bone fractures and orthopedic surgeries, as well as in certain non-traumatic conditions. The formation can be attributed to mechanical or biochemical processes. According to Hullman\u2019s biochemical hypothesis, elevated C-reactive protein levels facilitate the precipitation of very-low-density lipoproteins and chylomicrons, forming fat globules that may result in fat embolism. Based on the abovementioned hypothesis, this study aims to detect fat embolism in autopsy patients (postmortem) suffering from bronchopneumonia and determine its possible role as a cause of death. Methods: A group of autopsies of deceased individuals with bacterial purulent bronchopneumonia with confirmed or presumed elevated C-reactive protein levels was rigorously selected, excluding those with other potential causes of fat embolism such as cardiopulmonary resuscitation, hypothermia, and diabetes mellitus. Multiple organs were sampled for frozen section analysis using Oil Red O fat staining and assessed for the presence and extent of fat embolism. The Falzi score, as modified by Janssen, was employed for the lung tissue. Results: In 73% of the cases, predominantly sporadic, Grade 0 or Grade I fat embolism was observed; however, in none of the cases was fat embolism identified as the cause of death or as a significant contributing factor. Furthermore, neither fat embolism syndrome nor multiorgan fat embolism were detected. Conclusions: Although an elevated C-reactive protein level facilitates the formation of fat globules and fat embolism, its role as a direct cause of mortality remains uncertain. It may predispose individuals to such conditions and potentially interact with other factors, such as minor soft tissue trauma, to exacerbate the severity of fat embolism or its clinical manifestations. These findings underscore the necessity for further comprehensive investigations within the contexts of infection\/inflammation, fat embolism, and dyslipidemia.<\/jats:p>","DOI":"10.3390\/jcm14176097","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T15:03:14Z","timestamp":1756393394000},"page":"6097","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Nontraumatic Fat Embolism and Fat Embolism Syndrome in Patients with Purulent Bacterial Bronchopneumonia"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6779-1915","authenticated-orcid":false,"given":"Be\u00e1ta \u00c1gnes","family":"Borsay","sequence":"first","affiliation":[{"name":"Institute of Forensic Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5438-3856","authenticated-orcid":false,"given":"Barbara D\u00f3ra","family":"Halasi","sequence":"additional","affiliation":[{"name":"Institute of Forensic Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00f3bert Krist\u00f3f","family":"P\u00f3rsz\u00e1sz","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0638-5370","authenticated-orcid":false,"given":"Katalin","family":"K\u00e1rolyi","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Jefferson Einstein Hospital Philadelphia, 5501 Old York Rd, Philadelphia, PA 19141, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teod\u00f3ra","family":"T\u00f3th","sequence":"additional","affiliation":[{"name":"Department of Pathology, Ken\u00e9zy Gyula Campus, Clinical Center, University of Debrecen, Bart\u00f3k B\u00e9la \u00fat 2-26, H-4031 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0437-4072","authenticated-orcid":false,"given":"P\u00e9ter Attila","family":"Gergely","sequence":"additional","affiliation":[{"name":"Institute of Forensic Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"371","DOI":"10.3390\/forensicsci2020027","article-title":"Post-Trauma Combined Pulmonary Fat and Bone Embolism: Literature Review with Case Presentation","volume":"2","author":"Sablone","year":"2022","journal-title":"Forensic Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1177\/1925362119896351","article-title":"Fat Embolism, Fat Embolism Syndrome and the Autopsy","volume":"9","author":"Milroy","year":"2019","journal-title":"Acad. 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