J Rheum Dis.  2023 Oct;30(4):268-271. 10.4078/jrd.2023.0020.

Recurrent focal myofasciitis of Behçet syndrome mimics infectious myofasciitis: a case report

• Chung SW
• Lee JH
• Ha YJ
• Kang EH
• Lee YJ

• KMID: 2546243
• DOI: http://doi.org/10.4078/jrd.2023.0020

Abstract

Behçet syndrome (BS) is a chronic inflammatory disease with multiorgan manifestations. However, muscular involvement in BS has rarely been reported. Herein, we report the case of a 30-year-old male with BS who had recurring pain and swelling of the lower legs. The patient was administered antibiotics on several occasions as the condition was misinterpreted to be infectious myositis. Magnetic resonance imaging revealed myofascial involvement with focal necrotic lesions, and muscle biopsy revealed acute suppurative myositis with perivascular infiltration of polymorphonuclear leukocytes. His symptoms improved after treatment with corticosteroids. Azathioprine and colchicine therapy was beneficial for preventing further relapse after short-term corticosteroid treatment. Therefore, BS should be considered in the differential diagnosis of focal suppurative myofasciitis.

Keyword

Case reports; Behcet syndrome; Myositis; Myalgia; Myalgia

Figure

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  Fig. 1 Axial magnetic resonance imaging scans of the legs revealed gastrocnemius myofasciitis with a focal centrally necrotic lesion (arrow) and edematous change of the dermis and subcutaneous tissues 5 years ago (A) and 1 month ago (B). FS: fat suppressed, post-Gd: post-gadolinium enhancement.

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  Fig. 2 Muscle pathology of the peroneus longus. Acute suppurative myositis showing interstitial and perivascular infiltration (arrows) of inflammatory cells and abscess formation (asterisks). Main infiltrating cells were polymorphonuclear leukocytes (H&E, x200).

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