A 4-year-old boy presents to ED as his parents are concerned, he seems lethargic and sleepy | Medibuddy
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29th May 2023

A 4-year-old boy presents to ED as his parents are concerned, he seems lethargic and sleepy

A 4-year-old boy presents to ED as his parents are concerned, he seems lethargic and sleepy. On examination, he is pale with a distended abdomen and there is painless palpable lymphadenopathy in his axillary and cervical regions. His testes are mildly enlarged.

Preliminary blood tests reveal the following:
Hb 63 g/L (115-140 g/L)
WCC 23 x 10⁹/L (5-17 x 10⁹/L)
Neutrophils 0.6 x 10⁹/L 1.0-8.5 x 10⁹/L
Platelets 35 x 10⁹/L 150-400 x 10⁹/L

What is the most appropriate next investigation?

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