Clinical Practice and Cases in Emergency Medicine (May 2018)

Scurvy: Dietary Discretion in a Developed Country

  • Megan E. Perry,
  • Nathan Page,
  • David E. Manthey,
  • Joshua M. Zavitz

DOI
https://doi.org/10.5811/cpcem.2018.1.36860
Journal volume & issue
Vol. 2, no. 2

Abstract

Read online

Although the causes have changed, scurvy (vitamin C deficiency) is still diagnosed in developed countries. We report a case of an 18-year-old female who presented to our emergency department with thrombocytopenia, sinus tachycardia, hypotension, fatigue, gingival hyperplasia, knee effusion, petechiae and ecchymosis in lower extremities. The differential diagnosis included hematologic abnormalities, infectious etiologies, vasculitis and vitamin deficiency. A brief dietary history was performed revealing poor fruit and vegetable intake, thus increasing our suspicion for vitamin C deficiency. This experience illustrates the importance of a dietary history and reminds us to keep scurvy in the differential diagnosis.