A 5-year-old child presents with high fever lasting for 6 consecutive days. Physical examination demonstrates bilateral non-exudative conjunctival injection, erythematous cracked lips with a 'strawberry tongue', cervical lymphadenopathy, and induration of the hands and feet. What is the primary therapy to prevent coronary artery aneurysm formation?

Answer and explanation

Correct answer: C. Intravenous immunoglobulin (IVIG) and high-dose oral aspirin

  1. Step 1: Recognize diagnostic criteria for Kawasaki disease: Persistent fever days plus at least 4 of 5 principal criteria (conjunctivitis, oral mucositis, peripheral extremity changes, polymorphous rash, cervical lymphadenopathy).
  2. Step 2: Administering intravenous immunoglobulin (IVIG, 2 g/kg single infusion) along with oral aspirin within the first 10 days reduces the incidence of coronary artery aneurysms from 25% down to less than 4%.
Answer
Intravenous immunoglobulin (IVIG) and high-dose oral aspirin.
Why not the others: 'Penicillin' treats scarlet fever, which does not cause coronary aneurysms; 'Acyclovir' treats herpes infections; 'Cephalosporin' has no efficacy against Kawasaki vasculitis.

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