Typical Scurvy in an Atypical Patient: Case Report

Abstract

Vitamin C deficiency, also known as scurvy, is oftentimes considered a disease of only historic relevance. Our case report demonstrates that scurvy is still prevalent, and can arise in unexpected populations, such as college-aged individuals with imbalanced diets. This case study aims to report the clinical findings and treatment of a 19 year-old male college student diagnosed with scurvy. A thorough history was obtained from the patient, followed by a physical exam. The diagnosis of scurvy was made clinically and confirmed by additional laboratory testing of vitamin C levels. Treatment consisted of a daily over-the-counter vitamin C supplement and multivitamin, as well as nutritional counseling on consumption of adequate fruits and vegetables. The patient presented with scattered erythematous to light-brown eczematous patches, papules, and plaques on the trunk; perifollicular, erythematous, non-blanchable macules on bilateral lower extremities; and bilateral pedal edema. Serology for human immunodeficiency virus, syphilis, cytomegalovirus, Epstein-Barr virus, and Lyme disease was negative. Complete blood counts and a comprehensive metabolic panel were within normal limits except for mild leukopenia. Vitamin C level was < 0.1 mg/dL, with a reference range of 0.2–0.4 mg/dL. The patient began supplementing 1000 mg of vitamin C daily and introducing fruits and vegetables into his diet. Within 2 weeks, he reported remission of most major symptoms. Results are from one individual alone; therefore, there is a lack of generalizability, and caution should be taken with interpretation of these findings. This case exemplifies the importance of maintaining a high clinical suspicion of nutritional deficiencies, such as scurvy, even when a patient’s demographics are not typical for such conditions.