From Uncertainty to Clarity: Behçet's Disease Diagnosed in the Emergency Department

Behçet's disease is a complex, multisystem inflammatory vasculitis of unknown etiology, characterized by a highly heterogeneous clinical presentation that may delay recognition, particularly in the emergency setting. We report a case of a 15-year-old girl presenting to the emergency department with a first episode of painful genital ulceration associated with erythema nodosum and persistent fever. Laboratory investigations revealed a marked inflammatory syndrome without an identifiable infectious cause. Based on clinical findings and according to the International Criteria for Behçet's Disease (ICBD), a score of 5 was obtained, supporting the diagnosis. This case underscores the diagnostic challenges associated with early-stage Behçet's disease, especially in young patients presenting with incomplete or atypical clinical features. It highlights the importance of maintaining a high index of suspicion in the emergency setting to facilitate timely diagnosis and appropriate management.