<prompt> A 10-year-old child with short stature pallor, multiple petechiae, and hypoplastic thumb has HB of 7 g , normal reticulocyte count 1, hematocrit 25, and absolute neutrophil count 200cu mm. The most likely diagnosis isFanconis anemiaHIV bone morrow infectionHypersplenism induced bicytopeniaParvovirus B virus infection with transient erythro- blastopenia of childhood  <response>: Ans. a Fanconis anemia Ref. Nelson Textbook of Pediatrics, 19th ed.Ch. 489Neutropenia may be present with some viral infections, particularly parvovirus B19 infection; drug reactions; systemic lupus erythematosus; typhoid; brucellosis; and infiltrative diseases of the bone marrow, including lymphoma, leukemia, tuberculosis, and histoplasmosis.The rash of erythema infectiosum fifth disease, which is caused by human parvovirus B19, primarily affects children 3 to 12 years old; it develops after fever has resolved as a bright blanchable erythema on the cheeks slapped cheeks with perioral pallor.Educational point: Earliest feature of Fanconis anemia is pancytopenia. Filgastrim is drug used in Rx of febrile neutropenia. 