Actuality of juvenile dermatomyositis.

Juvenile dermatomyositis is a rare disorder, but remains the most commonly occurring chronic inflammatory myopathy among children. Other than the proximal muscles and skin, which are routinely affected, vasculopathy may affect other viscera and can be multisystemic. A redefinition of the diagnostic criteria is currently underway and is likely to lead to other clinical signs and to sensitive and non-invasive examinations such as MRI. The impact of juvenile dermatomyositis on health and quality of life remains significant despite systemic corticosteroid therapy and immunosuppressor treatment, which have considerably improved the prognosis. Numerous predictors for favourable and pejorative evolution have been identified. The standardisation and the generalisation of clinical assessment tools will make it possible to carry out the clinical trials required to determine the relevance of the new therapeutic options available for children.

[Lemierre syndrome]. / Syndrome de Lemierre.

Lemierre's syndrome is a rare and severe condition, with a primary focus in the cervicofacial area and followed by thrombosis of the internal jugular vein and metastatic infections, most often pulmonary. The principal pathogen is Fusobacterium necrophorum. Less rare and associated with high mortality before antibiotics, Lemierre syndrome had became exceptional until the increase in the number of cases in recent years. Recovery is usually the rule, but often only after long convalescence and often surgical intervention. The reemergence of this disease calls for a review of the literature to update knowledge about its epidemiologic, clinical, and therapeutic aspects.

Lemierre syndrome: once seen it can never be mistaken.

Lemierre syndrome is a rare but severe septicaemia due most frequently to Fusobacterium necrophorum, with primary foci in the head, internal jugular vein thrombosis and metastatic infections, mainly in the lungs. We report two cases of Lemierre syndrome admitted to the paediatric unit of our hospital at 2-month intervals. The first was 10 years old and the second one was a 3-month-old infant. They were diagnosed on the 25th hospital day and at the time of admission, respectively. In the first case, diagnosis was delayed due to unfamiliarity with this disease. In the second patient the diagnosis was established on the first day because of the recent experience with patient 1. In both cases, bacteriological investigations were not helpful. Both patients had a favourable outcome after prolonged antibiotic treatment, anticoagulation and surgical drainage.