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Case Reports
. 2008 Aug;23(8):1281-4.
doi: 10.1007/s11606-008-0577-1. Epub 2008 May 6.

Scurvy is still present in developed countries

Bertha Velandia  1 , Robert M Centor, Vicky McConnell, Mobin Shah
Affiliations
Case Reports

Scurvy is still present in developed countries

Bertha Velandia et al. J Gen Intern Med. 2008 Aug.

Abstract

Introduction: Scurvy, while uncommon, still occurs in developed countries despite the widespread availability of vitamins and fortified foods. A vitamin C deficiency prevalence of 10 to 14% in adults was reported in the National Health and Nutrition Examination Survey (NHANES) in 1994.

Objective: We report the case of a 57-year-old male who presented with a combined vitamin C deficiency (scurvy) and a Zinc deficiency.

Interventions: He came to the emergency department complaining of a painful swollen ecchymotic leg and dyspnea. Prescriptions for narcotics did not relieve his symptoms. When a detailed dietary history was obtained, we added scurvy to the differential diagnosis. An extensive evaluation excluded trauma, coagulopathies, neoplasia, and vasculitides.

Main result: The combination of a classic skin biopsy and a low vitamin C level confirmed the diagnosis.

Conclusion: This presentation illustrates the necessity of including scurvy in the differential diagnosis of ecchymoses and demonstrates specific populations at risk: single adults and the elderly with deficient diets.

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Figures

Figure 1
Figure 1
Hematoma in the left thigh and perifollicular petechiae.
Figure 2
Figure 2
Microscopic picture showing perifollicular hemorrhage, extravasation of erythrocytes.
See this image and copyright information in PMC

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