Undiagnosed Behçet’s disease presenting as Fournier’s gangrene in undiagnosed Behçet’s disease: a case report of a young adult male

Abstract

Behçet’s disease is a rare systemic condition, with the mean age of patients being ~30 years. It affects men more than women. Behçet’s disease should be considered in any patient with a systemic inflammatory disease characterized by recurrent orogenital ulcers and uveitis. Fournier’s gangrene is a rare life-threatening bacterial genital infection that acquires at any age with male predominance. A healthy 32-year-old male presented with fatigue, fever, oral ulcers, and discrete scrotal ulcers. He had Fournier’s gangrene and a new diagnosis of Behçet’s disease. He was treated with intravenous antibiotics with surgical debridement. Before discharge, the patient was commenced on 1 mg/day of colchicine. During the follow-up visits, we noted small ulcerations without necrosis on the scrotum, which we started with oral prednisolone and oral methotrexate. He remains under their care 6 months later. The patient had recurrent oral ulcerations followed by genital aphthous ulceration and acneiform eruptions that met Behçet’s diagnosing criteria. Fournier’s gangrene on the scrotum was diagnosed due to the physical examination, radiological findings, and histological findings. A PubMed search reveals one similar case report. This patient’s only risk factor for Bechet’s was his ethnicity and male gender for Fournier’s gangrene. The young adult patient presented unusually, with a diagnosis of Fournier’s gangrene superimposed on undiagnosed Behçet’s disease. An understanding of the epidemiology and risk factors can help in the diagnosis of these rare pathologies.