An 11-month-old infant presented to the emergency department with a history of intermittent fevers and recent onset of pallor, irritability, and "staring spells." An altered sensorium and marked hepatosplenomegaly (Fig 1) were present on physical examination. A peripheral smear, performed as part of a complete blood cell count, suggested an unexpected diagnosis (Fig 2). The Editors welcome contributions to Pathological Case of the Month, Picture of the Month, and Radiological Case of the Month. Those who wish to contribute should send their manuscripts to Dr Gilbert-Barness (Pathological Case of the Month), Department of Pathology, Tampa General Hospital, University of South Florida, Davis Island, Tampa, FL 33606; Dr Tunnessen (Picture of the Month), The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104; or Dr Wood (Radiological Case of the Month), Department of Radiology, Childrens Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027. Articles and
Epstein JE, Dyer BJ, Tunnessen WW. Picture of the Month. Am J Dis Child. 1993;147(10):1121–1122. doi:10.1001/archpedi.1993.02160340107025
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