15th February 2025

A five-year old boy is brought into A&E by his worried parents.

A five-year old boy is brought into A&E by his worried parents. He has vomited once, has abdominal pain and is delirious. On questioning his parents state that he has been more irritable and tired recently, although they had previously put this down to the disruption caused by moving and renovating their new house. On examination his gum margins are slightly tinged blue. What is the likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.