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February 1987

Leukocytosis in Infection

Arch Intern Med. 1987;147(2):197. doi:10.1001/archinte.1987.00370020017008

To the Editor.  —The presence of infection in man is often associated with leukocytosis in the peripheral blood. This phenomenon is most likely associated with acute bacterial infections, although it may be seen with nonbacterial acute infection and, occasionally, with chronic infections. It is also common knowledge that there is a so-called shift to the left with the number of bilobe and monolobe leukocytes increasing at the expense of those with more lobes. The amount of shift is proportional to the severity of the toxemia.Schilling, in 1929, 1 outlined the course of events in acute infection with a favorable outcome being related to leukocytosis with a shift to the left and disappearance of eosinophils and basophils and, later, a reduction in lymphocyte and monocyte counts. In Wintrobe's Clinical Hematology, published in 1942,3 he relates the cause of neutrophilia to pyogenic bacteria, particularly cocci, but this was also noted