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We are reporting a unique case of olmesartan associated severe sprue-like enteropathy in a 52-year-old woman who presented to our hospital complaining of severe abdominal pain and nausea. At the emergency department she suffered from a cardiac arrest and was found to have a colon perforation. The patient was treated conservatively without surgical intervention and olmesartan was discontinued. After one month, she had complete resolution of her symptoms.

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Clinical diagnosis of THS could be supported by radiological findings. According to the International Classification of Headache Disorders (ICHD)-3 beta diagnostic criteria, the diagnosis must be confirmed with an abnormal MRI and/or pathological sample. We add to the previous findings of THS with a normal MRI. Although MRI plays a crucial role in differential diagnosis, it should not, nor should the biopsy, be a must for the diagnosis. Limitations of using MRI in some patients are another problem.

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Streptococcus agalactiae (S. agalactiae), also referred as group B streptococcus (GBS), is an important pathogen in neonates and a rare cause of invasive infection in adults. It is well known that GBS endocarditis is a virulent infection that can cause serious complications. The overall mortality rate remains high despite surgical treatment. We describe a case of native mitral valve endocarditis caused by GBS in an 86-year-old woman treated medically.

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