Leptospirosis is a common tropical febrile illness which may manifest with the hepatorenal syndrome and systemic hemorrhagic manifestations. Pituitary apoplexy is a rare but life-threatening condition characterized by a hemorrhage within the pituitary gland or a pituitary adenoma. Apoplexy is very rarely associated with some inducing events such as infectious diseases such as dengue hemorrhagic fever, Hantaan virus, Puumala virus have also been reported to cause pituitary apoplexy. We present the first case of pituitary apoplexy in a patient who was being treated for leptospirosis and discuss the possible mechanisms of apoplexy in the scenario presented. We also review other reports of infectious causes that may result in pituitary apoplexy.

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Chiari malformation type 1 (CM 1) is defined asherniation ofcerebellar tonsils 4-5 mm below the foramen magnum. Multiple developmental factors like defective development of pontine flexure and shallow posterior fossa are the proposed factors which predispose the development of this syndrome. These reports on familial occurrence of this syndrome correlates with the embryonal- developmental etiology of Chiari 1 malformation. Recent advances in the understanding of the influence of genes and pathogenesis of familial Chiari malformation are expected to improve management of affected patients and monitoring of at-risk family members.

Osteosarcoma is a primary malignant neoplasm of the bone. Osteosarcoma of the jaws especially those of maxilla is rare. The diagnosis of osteosarcomas is diff icult and challenging. In this case report we highlight a rare case of osteosarcoma of the maxilla in a 29 year old male patient which was highly aggressive and was initially diagnosed as rhabdomyosarcoma. This case highlights the difficulty in diagnosing osteosarcoma merely from incisional biopsy specimens which may not be representative of the whole tumour. Limited clinical information at incisional biopsy also adds to the difficulty in arriving at the def initive diagnosis. We further discuss the treatment modalities followed in this case.