neutrophilia neutrophilia neutrophilia (also called neutrophil leukocytosis or occasionally neutrocytosis) is leukocytosis of neutrophils, that is, a high number of neutrophils in the blood. because neutrophils are the main type of granulocytes, mentions of granulocytosis often overlap in meaning with neutrophilia. neutrophilianeutrophils with a segmented nuclei surrounded by erythrocytes, the intra-cellular granules are visible in the cytoplasm (giemsa stained) the opposite of neutrophilia is neutropenia. causes neutrophils are the primary white blood cells that respond to a bacterial infection, so the most common cause of neutrophilia is a bacterial infection, especially pyogenic infections. neutrophils are also increased in any acute inflammation, so will be raised after a heart attack, other infarct or burns. some drugs, such as prednisone, have the same effect as cortisol and adrenaline (epinephrine), causing marginated neutrophils to enter the blood stream. a neutrophilia might also be the result of a malignancy. chronic myelogenous leukemia (cml or chronic myeloid leukaemia) is a disease where the blood cells proliferate out of control. these cells may be neutrophils. neutrophilia can also be caused by appendicitis and splenectomy. primary neutrophilia can additionally be a result of leukocyte adhesion deficiency. "left shift" a "left shift" refers to the presence of increased proportions of younger, less well differentiated neutrophils and neutrophil-precursor cells in the blood. this generally reflects early or premature release of myeloid cells from the bone marrow, the site where neutrophils are generated. a severe neutrophilia with left shift is referred to as a leukemoid reaction. the leukocyte alkaline phosphatase (lap) score, which refers to the amount of alkaline phosphatase per neutrophil, will increase. in a severe infection, toxic granulation changes happen to the neutrophils. this can resemble pelger-huet anomaly.