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Picture of the Month

Judith E. Epstein, MD; Bradley J. Dyer, MD; Walter W. Tunnessen Jr, MD
Am J Dis Child. 1993;147(10):1121-1122. doi:10.1001/archpedi.1993.02160340107025.
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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


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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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