Diff-Quik Cytologic Recognition Of Chlamydophila Psittaci In Orolabial Lesions Of Stevens-Johnson Syndrome A Case Report

BackgroundChlamydophila psittaci causes psittacosis, an ornithosis acquired usually from infected birds. The disease is often focal and pnemonic but on rare instances can be protean and fatal. Diagnosis is by Chlamydophila serology, which may take as long as 21 days or more. The recovery of the organisms from mice, eggs or tissue) sue culture inoculated with the patient's blood or sputum is tedious and dangerous for laboratory personnel. On occasion, C psittaci inclusion bodies have also been detected in infected cells by fluorescent antibody, Giemsa or Gimenez staining. This report describes heretofore not previously reported recognition of the causative organisms in Diff-Quick-stamed clinical cytologic materials.CaseA 17-year-old man presented with fiver and sore throat, associated with Steven-Johnson syndrome, of 6 days' duration. In the touch and scrape smears of the orolabial mucosal lesions, C psittaci inclusion bodies were recognizable in Diff-Quik stained but not with Papanicolaou-stained smears and Gram stain. There were few to numerous organisms per macrophage, which were enlarged or bloated and usually collared by polymorphonuclear leukocytes. The diagnosis was supported by a therapeutic trial with doxycycline and confirmed by a positive third serological tests for C psittaci 3 weeks after discharge.ConclusionIn a suspected or probable case of Ornithosis, a rapid diagnosis of C psittaci inclusion bodies is possible in clinical cytology materials using Diff-Quik. (Acta Cytol 2010;54:692-694)