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AKT8-117

Emma is 5 years old and rushed in to the GP surgery by her mother who is concerned she has gone very quiet and has a muffled voice. She complained of a sore throat earlier in the day and she has noticed she is now drooling and looks very unwell. Past medical history is unremarkable. From initial glance she looks grey.

Which one of the following features is the least associated with her likely diagnosis?

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