Chylopericardium rarely occurs in pediatric patients, but when it does it is most often a result of lymphatic injury during cardiothoracic surgery. Primary idiopathic chylopericardium is especially rare, with few cases in the pediatric literature. We report a 10-year-old boy who presented with primary idiopathic chylopericardium after unsuccessful initial treatment with surgical lymphatic ligation and creation of a pericardial window. Following readmission to the hospital for a right-side chylothorax resulting from the effluent from the pericardial window, he had successful treatment by interventional radiology with percutaneous thoracic duct embolization. This case illustrates the utility of thoracic duct embolization as a less-invasive alternative to surgical thoracic duct ligation, or as a salvage procedure when surgical ligation fails.

Encouraging patients' involvement in religion and certain coping strategies, especially among those families coping with children with special health care needs, may improve life satisfaction.

Fever in a returned traveler from the tropics often poses a diagnostic challenge to the emergency department physician because of the potential for serious morbidity and mortality associated with certain infections such as falciparum malaria and dengue. We report a case of imported dengue fever in a 15-year-old adolescent boy acquired during a recent travel to Guatemala. Dengue fever is a mosquito-transmitted viral infection of global importance. The majority of US residents with dengue become infected during travel to tropical areas. In recent years, dengue has remerged in US tropical and subtropical areas. The disease is underreported in the United States along the Mexican border. The epidemiology, clinical manifestations, diagnosis, control, and prevention of this important global reemerging infectious disease are reviewed. Clinicians should include dengue in the differential diagnosis of febrile illness in children who have recently returned from dengue endemic areas.