Le décollement épiphysaire post infectieux est une pathologie très rare, jamais décrite dans la littérature. Nous rapportons deux cas colligés au service: le 1er concerne un garçon âgé de 3 ans, admis pour impotence fonctionnelle du membre inferieur droit. La radiographie a objectivé un glissement de l’épiphyse fémorale supérieure par rapport à la métaphyse avec un épanchement échogène intra articulaire à l’échographie. Une artrotomie avec drainage ont été réalisé, puis le malade a été mis sous antibiothérapie et traction. L’évolution clinique a été bonne. Le 2ème cas est celui d'un garçon âgé de 12 ans, admis pour prise en charge d'une boiterie gauche évoluant dans un contexte fébrile. La radiographie a objectivé un glissement de l’épiphyse fémorale supérieure par rapport à la métaphyse, l’échographie a montré un épanchement intra articulaire gauche. L’évolution a été marquée par la régression du syndrome infectieux après l'arthrotomie de la hanche et l'antibiothérapie.

Osteoarticular tuberculosis represents 1.7-2% of all tuberculosis (TB). The localization in the foot is rare and accounts for less than 10% of osteoarticular TB. The following report describes the case of a 7-year-old boy who presented with a gradually increasing inflammatory swelling over the lateral aspect of the right ankle. An X-ray of his right ankle showed an osteolytic image at the calcaneus. Diagnosis was confirmed by the presence of a tuberculoid granuloma with caseous necrosis on bone biopsy.

Background The progress of diagnostic strategies and molecular methods improved the detection of Kingella kingae in bone and joint infections, and now, Kingella kingae is being increasingly recognized as the most frequent cause of bone and joint infection BJI in early childhood. The main objective of this prospective study is to report the frequency of Kingella Kingae in negative culture bone and joint pediatric infections, and to describe the clinical and biologic features of these children. Methods From December 2016 to June 2019, we selected all hospitalized patients with suspected BJI. When culture was negative on the fifth day, children under 10 years were subsequently included in the study, and PCR assay was performed systematically for researching K. kingae specific gene cpn60. Microbial culture and identification were made using standard bacteriological methods. The demographics, clinical, laboratory, radiographic and clinical features were reviewed from medical records. Results We enrolled 65 children with culture negative BJI, 46 of them having under 10 years old have been screened for the cpn60 gene. Thus, the gene encoding Kingella kingae was positive for 27 BJI cases (58.7%). The mean age of children was 3.02 years, 55.6% were aged 6 months-4 years and 29.6% of them were aged 5–10 years. The male to female ratio was 1.7 and 16 cases (59.26%) occurred during the fall-winter period. The most frequent BJI type was septic arthritis (77.8%) and the most affected sites were knee (51.9%) and hip (37.0%). We recorded a mild clinical picture with normal to mildly raised inflammatory markers. All patients had good clinical and functional outcomes, with no serious orthopedic sequelae.. Conclusion K kingae is an important pathogen of culture-negative BJI in Moroccan children. PCR testing should be performed in culture-negative cases of children not only in the typical age range of 6 months to 4 years. When implemented in the routine clinical microbiology laboratory, a specific K. kingae PCR assay can provide a better diagnostic performance of BJI.

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Le purpura rhumatoïde représente la vascularite immunoallergique la plus fréquente de l’enfant. Sa survenue dans les suites d'une vaccination antigrippale est exceptionnelle. Nous rapportons l’observation d’une fille de 4ans qui présente une suspicion de purpura rhumatoïde post vaccination antigrippale A(H1N1) compliqué d’invagination intestinale aiguë ayant bénéficié d’une réduction chirurgicale. L’évolution était favorable avec un recul de un an. L’invagination intestinale aiguë constitue la complication digestive la plus redoutable du purpura rhumatoïde. Dont le diagnostic doit être toujours évoqué devant des douleurs abdominales aigues chez un enfant porteur de cette vascularite.