A 3-year-old child presents with fever for 6 days, bilateral non-purulent conjunctivitis, strawberry tongue, cervical lymphadenopathy, and erythema of palms and soles. What therapy prevents coronary artery aneurysms?

Answer and explanation

Correct answer: D. Intravenous immunoglobulin and high-dose aspirin

  1. Step 1: Kawasaki disease is a medium-vessel systemic vasculitis predominantly affecting infants and young children, carrying a high risk of coronary artery aneurysms.
  2. Step 2: Prompt administration of high-dose intravenous immunoglobulin (2 g/kg) combined with high-dose aspirin within the first 10 days of fever dramatically reduces the incidence of coronary aneurysms from 25% to under 5%.
Answer
Intravenous immunoglobulin and high-dose aspirin.
Why not the others: Penicillin G treats streptococcal scarlet fever, which causes a strawberry tongue but lacks coronary vasculitis risks. Acyclovir treats herpes simplex and varicella, having no efficacy in Kawasaki vasculitis. Corticosteroids alone without IVIG are not standard primary therapy for acute Kawasaki disease.

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