Scurvy: Bilateral lower extremity ecchymoses and paraparesis

A 46-year-old man presented with two weeks of progressive paraparesis and large confluent ecchymoses of both thighs. There was a history of poor dietary intake and daily alcohol use. He had had similar problems each of the past two winters. In 1979 he required hospitalization for “sciatica.” In 1980 he was bedridden for two months because of lower extremity weakness. Examination revealed poorly fitting dentures, large confluent ecchymoses of both thighs, perifollicular hemorrhages, and a low serum ascorbic acid concentration. Oral ascorbic acid was begun in the hospital and all clinical symptomatic consequences of scurvy rapidly resolved. We present this case to reiterate the clinical presentation of scurvy and to emphasize the importance of recognizing early signs of nutritional deficiencies that may be confused with more common, but often less treatable, diseases.