Prolonged fever and intra-cardiac thrombosis revealing Behçet's disease

Abstract

Background: Prolonged fever (PF) is a challenging problem for physicians since it can be the first manifestation of a large variety of pathologies. Exceptionally, intra-cardiac thrombus (ICT) could explain PF and reveal Behçet's disease (BD). We are reporting a 45-year-old man with BD who has these unusual manifestations.

Case report: A 45-year-old man presented with PF and inflammatory biological syndrome during a few months. Echocardiography showed an inhomogeneous and mobile mass in the left auricle. During his hospitalization, the patient had multiple oral aphtosis. The angioscanner showed a sacciform aneurysm of the coeliac trunk. The diagnosis of BD was retained and he was treated with high doses of steroids and cyclophosphamide with a favorable follow-up.

Conclusion: The search for BD should be systematic in view of any suggestive manifestation of severe cardiovascular complications like ICT especially in a young adult man from a high endemicity region.

Keywords: Aneurism; Anévrysme; Aphtose; Aphtosis; Behçet's disease; Corticosteroids; Corticoïdes; Cyclophosphamide; Fever; Fièvre; Intra-cardiac thrombus; Maladie de Behçet; Thrombus intra cardiaque.