A 3-year-old child presented to the OPD with chief complaints of high-grade fever for 15 days along with a polymorphous exanthem all over the body, rhinorrhea, multiple episodes of vomiting, diarrhea and abdominal pain. O/E: - B/L conjunctival injection with limbal sparing Erythema of oral and pharyngeal mucosa Edema of hands and feet* Mild cervical lymphadenopathy at III and IV levels Lab findings: - Leucocytosis with neutrophilia and immature forms Elevated erythrocyte sedimentation rate* Elevated c-reactive protein Anemia Abnormal plasma lipids Hypoalbuminemia Hyponatremia. Coronary angiogram What should be the most impoant next step in the management of the child: -
Sta on IVIg only
Sta on aspirin only
Sta on both IVIg and aspirin
Sta on Clopidogrel only
This is a case of Kawasaki's disease presenting with coronary aery aneurysms. Image 1 shows classical strawberry tongue in Kawasaki's disease. Image 2 shows congestion of bulbar conjunctiva. Image 3 shows coronary aery aneurysms. Kawasaki disease (KD): - Also called as mucocutaneous lymph node syndrome and infantile polyaeritis nodosa. Predominantly affects the medium-size aeries Coronary aeries are the most commonly involved. Coronary aery aneurysms develop in up to 25% of untreated patients in the 2nd to 3rd wk of illness. In acute stage, treatment with both Aspirin and IVIg is staed.
Integrated QBank