**11. Clinical features**

FES usually presents as multisystem disorder in the setting of long bone fracture(s) or major trauma. The most commonly affected organs are brain and lung. The presentation is heterogeneous given diverse causes as well as multi-organ involvement. Latent period is typically 12 to 72 hours although rarely it can be as short as few hours in the setting of major trauma or as long as 2 weeks (Gary, 2004; Johnson & Lucas, 1996; M. B. King & Harmon, 1994; Mellor & Soni, 2001; Moreau, 1974; Parisi et al., 2002; Peltier, 1984; Schonfeld et al., 1983; Shier & Wilson, 1980). 85% of patients will develop signs and symptoms within 48 hours of injury (Sevitt, 1962). The classic triad of hypoxemia, neurological dysfunction and petechial rash is seen in only about 50% of the patients.
