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summary A 25 year-old woman presented with a painful mass in the left breast, polyarthritis and erythema nodosum. Fine needle aspiration cytology led to a diagnosis of granulomatous mastitis. Oral prednisolone rapidly improved the arthritis and the erythema nodosum. Granulomatous mastitis is a very rare, chronic inflammatory disease and only ten patients with granulomatous mastitis with erythema nodosum and polyarthitis have been described.

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Camurati–Engelmann disease (CED) or progressive diaphyseal dysplasia is a rare autosomal dominant inherited condition which belongs to the group of craniotubular hyperostosis. A 24-year-old man presented with insidious onset, progressive pain over both legs, and forearms for 3 years. He was born as the second child of a nonconsanguineous union by vaginal delivery at term without any complications. The clinical, radiological, and histopathological features were suggestive of CED. Transforming growth factor-β1 sequence analysis revealed a missense mutation (c.652C>T; p. Arg218Cys) confirming the diagnosis. He had a good response to treatment with Losartan. CED should be considered in the differential diagnosis of patients presenting with nonspecific limb pains and radiological features of skeletal dysplasia. Early recognition and diagnosis play a crucial role in management. This case discuss regarding the potential benefits of the drug losartan in the management of a rare bone disease for which the evidence from previous literature is scarce.

Endocarditis due to melioidosis is rare. A 60-year-old male was admitted with upper abdominal pain and vomiting for one month. Contrast enhancing computed tomography (CT) of the abdomen showed multiple hepatic, splenic and pancreatic nonenhancing cystic lesions. Culture of CT guided aspirate from the liver lesion showed growth of Burkholderia pseudomallei. He was started on ceftazidime and cotrimoxazole. Four days after admission patient developed decreased speech and response. Magnetic resonance imaging (MRI) and MR angioram brain showed massive infarct in the middle cerebral artery territory and occlusion of the middle cerebral artery. Echocardiogram showed vegetation in the aortic valve. He was diagnosed to have disseminated melioidosis with endocarditis resulting in massive infarct in the middle cerebral artery territory.