A 5-year-old boy presents with high fever for 6 days, bilateral bulbar conjunctival injection without exudate, erythematous cracked lips, cervical lymphadenopathy (2 cm), and desquamation of the fingertips. Echocardiogram shows coronary artery dilation. What is the first-line treatment regimen?

Answer and explanation

Correct answer: B. High-dose IVIG (2 g/kg) plus high-dose oral Aspirin

  1. Step 1: Fever >= 5 days with mucocutaneous lymph node syndrome features and coronary artery dilatation confirms Kawasaki Disease.
  2. Step 2: The primary goal is reducing the risk of coronary artery aneurysms from 25% to < 5%.
  3. Step 3: Guideline standard of care is intravenous immunoglobulin (IVIG) 2 g/kg in a single infusion administered within 10 days of fever onset, combined with high-dose aspirin (80-100 mg/kg/day during acute phase).
Answer
High-dose IVIG (2 g/kg) plus high-dose oral Aspirin.
Why not the others: Corticosteroid monotherapy is not first-line; antibiotics do not treat Kawasaki vasculitis; anticoagulants are reserved for giant aneurysms.

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