<P> It is usually noted on microscopic examination of a blood smear . This systemic effect of inflammation is most often seen in the course of an active infection and during other severe illnesses such as hypoxia and shock . Döhle bodies may also be present in the neutrophil's cytoplasm in the setting of sepsis or severe inflammatory responses . </P> <P> It is believed that cytokines (including IL - 1 and TNF) accelerate the release of cells from the postmitotic reserve pool in the bone marrow, leading to an increased number of immature cells . </P>

Leukocytosis with a shift to the left refers to