1999 Volume 38 Issue 4 Pages 320-322
Background: Although chlamydial conjunctivitis is a common disease, there have been few cytological reports published. Here we describe a case that was examined both cytologically and immunocytochemically.
Case: A 67-year-old man presented with conjunctival injection and increased eye discharge. Ophthalmologic examinations revealed prominent follicle formation in the conjunctiva, and lymph node swelling in the bilateral preauricular regions was also noted. Chlamydial conjunctivitis was suspected, and brush cytology of the conjunctiva was performed. Diff-Quik-stained sections revealed inclusionlike bodies in the cytoplasm of the epithelial cells. Fine, highly dense granular or reticular bodies, red-purple in color were occasionally detected in the epithelial cells, a number of which also contained basophilic and rather coarse granules. Immunostaining for Chlamydia using bleached Diff-Quikstained sections indicated that only the latter structures showed a positive reaction, whereas the former seemed to be pseudo-inclusions.
Conclusions: Although Prowazek bodies are known to be typical chlamydial inclusions, this is not always true, and inclusions that do not show the typical morphology have also been reported by other authors. Thus, immunostaining is considered to be useful for accurate diagnosis of chlamydial conjunctivitis from cytology specimens. This method seems more beneficial than other antigen detection methods such as immunofluorescence or enzyme immunoassay, because it shows more detailed morphology of the inclusions.
