# Fever, Leukocytosis, and Ulcerated Vulvar Lesions: An Atypical Presentation Concerning Behcet’s Disease

## TL;DR

A patient with sepsis-like symptoms and ulcers was suspected to have Behcet’s disease, a rare inflammatory condition.

## Contribution

This case highlights an atypical presentation of Behcet’s disease mimicking sepsis.

## Key findings

- The patient presented with fever, leukocytosis, and ulcerated vulvar lesions.
- Herpetiform oral mucosal lesions were also observed, raising suspicion for Behcet’s disease.
- The case emphasizes the diagnostic challenge of Behcet’s disease in acute settings.

## Abstract

Behcet’s disease (BD) is a variable-vessel vasculitis commonly presenting in early adulthood with painful oral aphthous ulcers, genital ulcers, uveitis, pathergy, and skin lesions. The diagnosis of BD is made clinically based on criteria from the International Study Group (ISG) and the International Criteria for Behcet’s Disease (ICBD). Due to the wide constellation of symptoms BD can cause, it can be challenging to diagnose in an acute setting. Here, we discuss a patient who presented with a clinical picture of sepsis, with profound ulcerated vulvar and herpetiform oral mucosal lesions, that led us to a presumptive diagnosis of Behcet’s disease.