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Scurvy presenting in a homeless 32-year-old male: a case report

European Journal of Clinical Nutrition (2024)Cite this article

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Abstract

Vitamin C deficiency, otherwise known as scurvy, is one the oldest known diseases. Although its prevalence has substantially diminished, certain populations such as smokers, alcoholics, elderly, and those with malabsorptive syndromes remain at risk. Deficiency presents with perifollicular hemorrhage, corkscrew hairs, and petechiae that can evolve into ecchymoses and purpura. Diagnosis starts with clinical suspicion and is confirmed with plasma and leukocyte ascorbic acid levels. Early suspicion is key. Treatment with vitamin C offers an excellent prognosis and avoids unnecessary workup for differential diagnoses. In our case, a 45-year-old male alcoholic with progressively worsening symptoms was found to have scurvy. Treatment was initiated with vitamin C supplementation, and he had remarkable improvement in his symptoms within weeks. This case demonstrates that scurvy is not a disease of history and must be considered in modern medicine, especially as homelessness with concomitant poor nutrition continues to increase.

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Fig. 1: Oral cavity examination.
Fig. 2: Inner thigh examination.

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Funding

Funding was not involved in the manuscript writing, editing, approval or decision to publish.

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Authors and Affiliations

  1. Department of Internal Medicine, Orlando Health, Orlando, Florida, USA

    Thomas Sun, Brian Shaw & Jorge Cusco

  2. Department of Hematology Oncology, Orlando Health, Orlando, Florida, USA

    Jacqueline Kropf & Tirrell Johnson

  3. Division of Academic Affairs and Research, Orlando Health, Orlando, Florida, USA

    S. J. Carlan

Authors
  1. Thomas Sun
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  2. Brian Shaw
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  3. Jorge Cusco
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  4. Jacqueline Kropf
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  5. Tirrell Johnson
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  6. S. J. Carlan
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Contributions

Writing the initial draft of the manuscript: BS, EB, JK, TS, Conceptualization and supervision: JC, TJ, TS, Medical management of the case: EB, JK, JC, Revising the manuscript critically and literature review: SC, BS, EB, TJ, TS.

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Correspondence to S. J. Carlan.

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The project did not meet the definition of human subject research under the purview of the IRB according to federal regulations and therefore was exempt.

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Sun, T., Shaw, B., Cusco, J. et al. Scurvy presenting in a homeless 32-year-old male: a case report. Eur J Clin Nutr (2024). https://doi.org/10.1038/s41430-024-01498-6

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  • DOI: https://doi.org/10.1038/s41430-024-01498-6

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