Wozniak Phillip S, Rampon Garrett L
Department of Pediatrics, Children's Mercy Kansas City, Kansas City, USA.
Department of Internal Medicine, University of Missouri Kansas City School of Medicine, Kansas City, USA.
Cureus. 2023 Jul 3;15(7):e41318. doi: 10.7759/cureus.41318. eCollection 2023 Jul.
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.
蓝绿色胞质嗜中性包涵体，以前被描述为“死亡的绿色晶体”，在重症患者中是一种罕见但可能未被充分报道的发现。这一发现与高死亡率相关，在已发表的病例研究中，死亡率从31%到100%不等。这些包涵体与急性肝损伤和乳酸性酸中毒的关联最为密切，但也有报道称在其他病因导致的重症患者中出现。在此，我们报告一例因误吸性肺炎和肠穿孔继发严重气腹的患者出现蓝绿色嗜中性包涵体的病例。这些蓝绿色嗜中性包涵体对医生具有很高的预后价值，它们的存在应被视为一个“关键结果”，表明患者病情的严重程度。
