Neutrophils with bright green inclusions in a patient with chest pain

Li, Zuojie; Ye, Chunmei; Chen, Yanxia; Liu, Jinlin

doi:10.1111/ijlh.13939

Cited by 1 publication

(2 citation statements)

References 2 publications

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“…A review of the current literature suggests a strong temporal association between the identification of the inclusion bodies and the subsequent onset of multisystem organ failure, irrespective of the patient's specific underlying illness [8][9][10]. Thus, once these inclusion bodies have been identified, this critical result should lead physicians to consider implementing more invasive vital sign monitoring, more frequent lab draws, and additional imaging to evaluate for worsening organ injury or failure.…”

Section: Discussionmentioning

confidence: 99%

“…While acute liver injury and elevated lactic acid have been closely linked to the development of these inclusion bodies, it remains to be determined whether these inclusion bodies result from hepatic ischemia in the setting of septic shock or direct hepatotoxicity [1,3,7,[9][10][11]. The specific mechanism by which these inclusion bodies develop and what material constitutes these inclusion bodies are unknown.…”

Section: Discussionmentioning

confidence: 99%

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Green Cytoplasmic Neutrophilic Inclusion Bodies in a Patient With Aspiration Pneumonia and Bowel Perforation

Wozniak¹,

Rampon²

2023

Cureus

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Blue-green cytoplasmic neutrophilic inclusion bodies, previously described as "green crystals of death," are a rare but likely underreported finding in critically ill patients. This finding is associated with high mortality, ranging from 31% to 100% in published case studies. These inclusion bodies have been most strongly associated with acute liver injury and lactic acidosis, but they have also been reported in critically ill patients secondary to other etiologies. Here, we report a case of blue-green neutrophilic inclusion bodies in a patient with aspiration pneumonia and severe pneumoperitoneum secondary to bowel perforation. These blue-green neutrophilic inclusion bodies offer high prognostic value for physicians, and their presence should be considered a "critical result," indicating the severity of the patient's illness.

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Section: Discussionmentioning

confidence: 99%