A 2-year-old boy has been ill with fever for almost 1 week

A 2-year-old boy is brought in by his parents, who are concerned that he has been ill with fever for almost 1 week. They report that he had some fussiness and runny nose 1 week ago followed by fever to 101.5°F intermittently for the last 5 days. He has had no household ill contacts, and he has not had any diarrhea or emesis.

At the time of examination, he has temperature of 38.3°C and mild tachycardia. He is not lethargic. Eyes have conjunctival injection, particularly at the periphery, but there is no conjunctival discharge. He has anterior tender cervical lymphadenopathy. His lips are red and cracked, and his tongue is erythematous and slightly enlarged. He has tonsillar adenopathy without exudate. His tongue and lips are shown in the Figure.

Figure.

Of the following, which therapy is most likely to benefit this child?

• oral penicillin VK 50 mg/kg/day
• oral prednisone 1 mg/kg
• intravenous immunoglobulin (IVIG) and aspirin
• acetaminophen scheduled every 4 hours

This question appears in Med-Challenger Family Medicine Exam Review with CME

Try for free and save. Ace your exams and meet your CME/MOC requirements for just $35 a month!