The term 'left shift' indicates that the neutrophils present in the blood are at a slightly earlier stage of maturation than usual. This is often seen in acute infections, when toxic granulation and 'Dohle Bodies' may also be seen. Early neutrophils are often referred to as 'band cells', because of the unsegmented nucleus. The stage before this can also be seen, the metamyelocyte. In severe infections, sometimes even myelocytes may appear in the blood. Other severe ilnesses, such as hypoxia and shock, can also cause a left shift. The Dohle bodies are the blue smudges present just under the outer membrane of the cell.