"Blue-body" epithelial cell inclusions in conjunctivitis

Area of Science:

• Ophthalmology
• Cell Biology
• Toxicology

Background:

• Conjunctivitis is a common ocular condition.
• Epithelial cell inclusions can be indicative of various pathologies, including infections and cellular injury.
• Distinguishing between infectious and non-infectious causes is crucial for appropriate patient management.

Purpose of the Study:

• To investigate the nature and etiology of previously unidentified basophilic cytoplasmic inclusions found in conjunctival epithelial cells.
• To determine the association between these inclusions and clinical findings or medication use.
• To evaluate the diagnostic significance of these inclusions in conjunctivitis.

Main Methods:

• Analysis of conjunctival scrapings from 1731 patients with conjunctivitis (1970-1980).
• Giemsa staining to identify basophilic cytoplasmic inclusions ("blue-bodies").
• Electron microscopy to characterize the morphology and composition of the inclusions.
• Statistical analysis to correlate inclusion presence with medication use and clinical presentation.

Main Results:

• Basophilic cytoplasmic inclusions were identified in 10.4% of conjunctival scrapings.
• Electron microscopy revealed inclusions composed of dense bodies and phagolysosomal vacuoles with complex lipids, suggesting epithelial cell injury.
• A significant association was found between the presence of these inclusions and the use of topical medications, particularly Neosporin.
• Prolific inclusions correlated with subacute to chronic conjunctivitis or blepharoconjunctivitis, suggestive of hypersensitivity.

Conclusions:

• The identified "blue-bodies" represent drug-induced epithelial cell injury, likely a hypersensitivity reaction to topical medications.
• These inclusions are morphologically distinct from infectious agents.
• Recognizing these inclusions aids in differentiating drug reactions from infections in conjunctivitis cases.