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Anorectal malformations (ARM) are the result of an abnormal development of the terminal part of the digestive tract interesting anus and/or rectum that occur early between the sixth and tenth week of embryonic development. They carry a malformation spectrum of severity depending on the level of disruption of the anorectal canal and of the associated caudal malformations (sacrum and spine). ARM are associated in over half the cases with other malformations that can be integrated in some cases in known syndromes. If surgical treatment to restore anatomy as normal as possible is indispensable, post-operative care is essential for these patients whose defecation mechanisms are altered, to reach if not continence, at least a socially acceptable cleanliness.

Pain associated with vaso-occlusive crisis is the main cause of hospitalization in children with sickle cell disease. Recent studies have suggested that pain might have a neuropathic component. Lidocaine patches are commonly prescribed as a topical analgesic in adult neuropathic pain. This study reports the efficacy and safety of such treatment in 6 patients with sickle cell disease, aged 6-18 years, who had been hospitalized for vaso-occlusive crisis after failure of the standard analgesic treatment. These data have led to setting up a confirmatory phase II trial, which is currently underway.

Neisseria meningitidis is associated with severe invasive infections such as meningitis and fulminant septicemia. Septic arthritis due to N. meningitidis is rare and bone infections have been reported exceptionally. We report the case of a 7-year-old boy who presented with septic arthritis of the right hip associated with a septic location on the pelvis and pyomyositis of the adjacent muscle. Culture of the joint fluid was sterile but universal 16S polymerase chain reaction (PCR) of this fluid revealed group B N. meningitidis. Our patient had never presented any symptoms of meningitis or septicemia and blood cultures were all sterile. Despite appropriate antibiotic treatment, the course of the disease was unusually long and his status did not improve until surgical lavage of the hip was performed. Moreover, MRI imaging showed bilateral hypersignals of the adjacent muscles and revealed an abscess formation in the left gluteus maximus muscle. Presumptive diagnosis bacterial myositis was confirmed by an elevation of creatine phosphokinase in the sera up to 21-fold the normal value but the culture of the abscess, performed 10 days after initiation of antibiotics, was sterile. Despite an initially unfavorable course, this patient's status improved after surgical drainage and he fully recovered 1 month later. This observation illustrates an unusual presentation of invasive meningococcal infection. The respective roles of infection and an inflammatory phenomenon during the course of the disease are discussed. Moreover, this case emphasizes the value of PCR for bacteriological diagnosis of bone and joint infections.