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A case study of neutrophil-specific granule deficiency (NSGD) is presented. The patient was a 25-year-old male who was referred for further investigation of chronic neutropenia, monocytosis and recurrent bacterial infections from an early age. An automated full blood count showed normal hemoglobin, white blood cell and platelet count and an apparent neutropenia and monocytosis. A blood film showed neutrophils with reduced granulation and incomplete nuclear segmentation with some bilobed forms.