Is Behçet’s syndrome associated with infection?

Staphylococcus aureus grew from both the dermal pustules and the pustular pathergy lesions. [...]far there have been few formal studies of antibiotic use in BS. calguneri et al reported that penicillin treatment was beneficial for the mucocutaneous lesions 1 and arthritis. 2 A similar beneficial effect was observed with minocycline, which reduced both the frequency of clinical symptoms and the production of inflammatory cytokines by peripheral blood mononuclear cells stimulated by streptococcal antigens. 3 The issue of an infectious aetiology in BS has also long been discussed. In one study peripheral [GAMMA]δ+CD8+T cells of patients with BS showed a significantly proliferative response to the Streptococcus sanguis strain KTH-1. 7 In another, T cells from patients with BS produced interferon [GAMMA] when stimulated with staphylococcal superantigens. 8 Clinical evidence for the role played by an infectious agent in pathogenesis includes the presence of a higher incidence of chronic tonsillitis and dental caries in patients with BS, 9 observation of exacerbations of BS symptoms after acute episodes of infection with Streptococcus agalactiae vaginitis, 10 and gingival infections with methicillin resistant Staphylococcus aureus. 11 There are also reports from our group showing the association of papulopustular lesions with arthritis in BS, suggesting a reactive type of arthritis. 12, 13 Lehner and colleagues suggested that a common antigen such as a stress protein might be involved. 14 A significant increase of IgA antibodies to mycobacterial 65 kDa heat shock protein (HSP) in the serum of patients with BS was shown.