A 3-year-old boy, with no relevant family/personal history, presented at the emergency department due to recurrent left hemifacial erythematous oedema and feverish peak. The mother reported two similar episodes in the previous months, interpreted as periorbital cellulitis, with resolution with systemic antibiotic and oral corticosteroid. She denied fever, weight loss or other constitutional symptoms. At examination presented skin paleness; soft, non-tender swelling and erythema of the left periorbital region (Figures 1); shotty, non-tender, well defined, smooth generalised lymphadenopathy (cervical, submaxillary, axillary, …