A 3-year-old boy has had 5 days of fever, bilateral non-purulent conjunctivitis, cracked red lips, cervical lymphadenopathy and a polymorphous rash. Which management is correct?
Answer and explanation
Correct answer: D. Intravenous immunoglobulin 2 g/kg as a single infusion, with aspirin and baseline echocardiography
- Step 1: Fever for five days with four of five principal features is classical Kawasaki disease.
- Step 2: IVIG 2 g/kg given within 10 days of onset lowers the risk of coronary artery aneurysms, aspirin is added, and echocardiography establishes baseline coronary status.
Answer
Intravenous immunoglobulin 2 g/kg as a single infusion, with aspirin and baseline echocardiography.
Why not the others: Corticosteroids are adjunctive in high-risk cases; aspirin alone does not prevent aneurysms; antibiotics do not treat this vasculitis.
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