A 35-year-old previously healthy man presented with orogenital ulcerations, high fever, weight loss and leg thrombosis. Antibiotics were ineffective. His symptoms persisted and 3 years later he suffered from exertional dyspnoea. Inflammatory markers were elevated and all cultures were negative. CT of the thorax showed bilateral pulmonary embolism and a mass attached to the septum of the right ventricle, as well as an occluded vena cava inferior. Histology of the cardiac mass revealed a thrombus. The pulmonary embolisation progressed despite treatment with full-dose dalteparin. After being diagnosed with Behçet's disease, a multisystemic large-vessel vasculitis, and treated with high-dose prednisolone and cyclophosphamide, his ulcerations and his symptoms of dyspnoea disappeared. Copyright 2015 BMJ Publishing Group. All rights reserved.

[No Keywords available]

Behcet disease differential diagnosis Pulmonary Embolism cyclophosphamide erythrocyte sedimentation rate refugee piperacillin plus tazobactam warfarin vasculitis thrombosis inferior cava vein obstruction dalteparin drug megadose inferior cava vein ulcer cachexia Syrian Arab Republic complication follow up heart right ventricle human heart sarcoma Refugees Heart Ventricles Behcet Syndrome thrombophlebitis antibiotic agent Vitamin D prednisolone lung infarction pericardial effusion pathology priority journal proton pump inhibitor Vena Cava, Inferior heart myxoma leg thrombosis heart tumor Colchicine lung embolism Humans human tissue transthoracic echocardiography weight reduction male case report mouth ulcer lymphoma computed tomographic angiography Heart Diseases Article cotrimoxazole Syrian fever adult pleura effusion Syria computer assisted tomography dyspnea heart ventricle thrombosis appetite Physical Examination heart ventricle leg disease