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Reminder of important clinical lesson
2011: the scurvy Odyssey
  1. V R Bernardino1,
  2. Pedro Mendes-Bastos2,
  3. Carla Noronha3,
  4. Celia Coelho Henriques1
  1. 1Department of Internal Medicine 2, Hospital Curry Cabral, Lisbon, Portugal
  2. 2Department of Dermatology and Venereology, Hospital Curry Cabral, Lisbon, Portugal
  3. 3Department of Autoimmunes Diseases Unit, Hospital Curry Cabral, Lisbon, Portugal
  1. Correspondence to Dr V R Bernardino, verarodber{at}


The authors report the case of a 50-year-old alcoholic man with chronic hepatitis C virus infection, who presented to the emergency department with fever and exuberant ecchymoses and petechiae on both legs. After a careful examination and laboratory assessment, the not-so-obvious hypothesis of scurvy was disclosed. Simply with vitamin C replacement and nutritional advice, a dramatic improvement in his condition was observed. In modern societies, a generalised access to food renders scurvy as a rare disease, often misdiagnosed. A multidisciplinary approach is emphasised as the key to a more simple differential diagnosis, avoiding unnecessary exams and preventing serious complications, or even death, if left untreated.

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