15 year old male, post renal transplant on tacrolimus (immunosupressive agent) was admitted with diarroea. Complete work up including hemogram was done. Review of peripheral smear showed presence of neutrophilic leucocytosis with left shift and  intracytoplasmic round Howell - Jolly body -like inclusions inside the neutrophils. 

These are seen in Human immunodeficiency virus (HIV), post transplant patients on immunosupression and in patients on chemotherapy.