paeds696
A 3-year-old girl presents with pallor and marked gland enlargement. She has been unwell for the past three weeks. She had a full term normal delivery with no neonatal problems. Her immunisations are up to date. There is no family or social history of note. On examination, her temperature is 37.6°C, and she looks pale and unwell. She has a few petechiae on the neck and palate, with moderate generalised lymphadenopathy and a 3 cm spleen. Which is the most likely diagnosis?