Histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto disease) with CNS involvement in a child.

We describe the case of a 9-year-old boy with encephalitis associated with histiocytic necrotizing lymphadenitis (HNL), also known as Kikuchi-Fujimoto disease. The child presented with unilateral cervical lymphadenopathy and fever that evolved to encephalitis in 3 weeks. Brain MRI showed bilateral temporal lobe hyperintense signal on T2 and FLAIR, hyperintense FLAIR signal in the periaqueductal gray matter, medial walls of the third ventricle, and mammillary bodies, multiple diffusion restriction foci in a central perivascular distribution and central perivascular enhancement. The perivascular distribution and nodularity of the diffusion restriction seen in this case has not been previously reported in HNL encephalitis.

Psychological Care of the Family of Children with Medical Complexities.

Advances in medical knowledge and treatments have made possible the survival of children with diseases that require lifelong care, and increasing numbers of families with children with medical complexity are presenting for health care. Owing to an increase in home-based care, the responsibility of complicated treatment regimens falls on parents and family caregivers. Based on studies and national survey, parents of children with medical complexity fare worse in mental health and family functioning. This review describes screening tools and research studies for family functioning and psychological health. These data also help in designing a family centered approach to the care of parents and caregivers to create a medical home and community support systems that integrate psychological and emotional interventions. Physician communication can be optimized by educational tools of brief intervention and community connections. [Pediatr Ann. 2024;53(3):e93-e98.].