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: -
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.
Sta on IVIg only
Sta on aspirin only
Sta on both IVIg and aspirin
Sta on Clopidogrel only
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