Case of Epididymitis Leading to Diagnosis of Incomplete Behcet's Disease

A 50-year-old male was diagnosed with acute epididymitis and treated with levofloxacin, however, no improvement was noted. The patient was thus referred to our department for further examinations and treatment. While there were no results indicating pyuria, ceftriaxone was started for acute epididymitis based on clinical findings, though the condition did not improve. Epididymal abscess was suspected, and CT and MRI examinations were performed, which only revealed swelling of the epididymis. The patient was then referred to the Department of Rheumatology for a fever of unknown origin and tested for various autoantibodies, all of which were negative, though gallium scintigraphy showed accumulation in multiple joints. Behcet's disease was suspected and colchicine treatment started, which resulted in a dramatic relief of symptoms. Subsequently, fundus angiography revealed fern-like fluorescent leakage. Furthermore, painful ulcers were found in the oral cavity, leading to a final diagnosis of incomplete Behcet's disease. Presently, colchicine treatment is continuing and there has been no recurrence.