Open AccessDisease of the past re-emerging in modern Australian society
Author(s) -
Mohammed Arif Uddin,
Christopher Robson,
Ravindra Dotel
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2018-228448
Subject(s) - medicine , ecchymosis , differential diagnosis , rash , thrombocytosis , disease , scurvy , dermatology , vasculitis , rare disease , clotting factor , myositis , surgery , pediatrics , vitamin c , pathology , platelet
A 28-year-old man with fever, atraumatic lower limb pain and rash was noted to have multiple areas of ecchymosis involving both lower limbs. He was anaemic and also had a grossly swollen left leg. Differential diagnoses of compartment syndrome, vascular tear, platelet and clotting factor disorders, vasculitis and myositis were ruled out. Scurvy was only considered after failing to reach a diagnosis. A dietary history revealed consumption of a restricted diet with no fresh fruits or vegetables. Diagnosis was supported by an undetectable vitamin C level in blood and a rapid improvement of symptoms on oral vitamin C replacement. Prevalence of vitamin C deficiency in developed countries is also discussed.