Doctors discovered that a 55-year-old man with severe bruising and leg pain actually had scurvy—a disease most people think only happened hundreds of years ago to sailors. Scurvy happens when someone doesn’t eat enough fruits and vegetables for a long time, causing their body to lack vitamin C. The man’s limited diet due to his digestive condition left him vulnerable to this rare but treatable problem. After doctors figured out what was really wrong, simple vitamin C supplements quickly helped him feel better. This case reminds doctors to ask patients detailed questions about what they eat, especially when standard tests don’t explain their symptoms.

The Quick Take

  • What they studied: Why a middle-aged man developed severe bruising, bleeding under the skin, and leg pain that doctors couldn’t initially explain
  • Who participated: One 55-year-old man with Crohn’s disease (a digestive condition) who had been eating a very limited diet without fruits or vegetables
  • Key finding: The man had scurvy from vitamin C deficiency, not a blood clot or medication side effect as initially suspected. Vitamin C supplements quickly reversed his symptoms.
  • What it means for you: If you have unexplained bruising or bleeding, doctors should ask about your diet. Scurvy is rare but still happens, especially in people with digestive problems or very limited diets. It’s easily fixed with vitamin C, but only if doctors think to check for it.

The Research Details

This is a case report, which means doctors documented one patient’s medical story in detail. The 55-year-old man came to the hospital with painful legs and large bruises that appeared without injury. Doctors initially thought he might have a blood clot in his leg or a medication side effect causing bleeding problems. They ran standard blood tests and imaging scans, but these didn’t show what was wrong. The doctors then took a very careful history of what the patient ate and noticed he almost never ate fruits or vegetables because of his digestive condition. They also found a specific type of rash called follicular purpura, which is a classic sign of scurvy. This combination of clues led them to the correct diagnosis.

Case reports are important because they remind doctors about rare conditions that are easy to miss. Scurvy disappeared from most developed countries decades ago, so modern doctors might not think of it first. By publishing this case, the doctors help other medical professionals recognize scurvy if they see it in their own patients. This is especially important for people with chronic illnesses who might have restricted diets.

This is a single case report, so it shows what happened to one person but cannot prove the same thing will happen to everyone. However, the diagnosis was confirmed through physical examination findings and the patient’s rapid improvement with vitamin C treatment, which strengthens the case. The detailed dietary history was crucial to solving the mystery.

What the Results Show

The patient presented with severe bilateral leg pain and extensive bruising on both lower legs that significantly limited his ability to walk. Initial investigations including blood tests and imaging did not reveal a blood clot or bleeding disorder. Physical examination revealed follicular purpura—small red bumps around hair follicles with bleeding, a classic sign of scurvy. The patient’s detailed dietary history revealed he had been eating an extremely limited diet lacking fruits and vegetables for an extended period due to his Crohn’s disease. Blood work eventually confirmed vitamin C deficiency. After starting vitamin C supplementation, the patient experienced rapid improvement in his symptoms, pain decreased, and the bruising resolved.

The case demonstrates how chronic illnesses like Crohn’s disease can indirectly lead to nutritional deficiencies by limiting what patients feel comfortable eating. The patient’s initial symptoms could have been mistaken for serious conditions like deep vein thrombosis or medication-induced bleeding problems, which would have led to unnecessary and potentially harmful treatments. The physical examination finding of follicular purpura was key to pointing doctors toward the correct diagnosis.

Scurvy was common in sailors and populations without access to fresh food centuries ago, but it’s rare in modern developed countries. This case is notable because it shows scurvy still occurs today in people with restricted diets, particularly those with chronic digestive conditions. Previous medical literature has documented scurvy in similar populations, but it remains underdiagnosed because doctors don’t always think to look for it.

This is a single case report involving one patient, so the findings cannot be generalized to all people with similar conditions. We don’t know how common scurvy is among people with Crohn’s disease or other digestive conditions. The case doesn’t provide information about how long vitamin C supplementation was needed or whether the patient maintained improvement long-term. Additionally, the title mentions clozapine-induced bluish discoloration, but the abstract focuses on scurvy, creating some confusion about the actual diagnosis.

The Bottom Line

If you have unexplained bruising, bleeding, or leg pain, ask your doctor to consider nutritional deficiencies as a possible cause, especially if you have a restricted diet. Make sure your doctor knows everything you eat and don’t eat. If you have a chronic digestive condition that limits your diet, discuss vitamin supplementation with your healthcare provider. Eat fruits and vegetables regularly if possible, or take vitamin C supplements if you cannot eat them. (Moderate confidence—based on one case, but supported by established medical knowledge about vitamin C deficiency.)

People with Crohn’s disease, celiac disease, or other digestive conditions that limit food choices should pay special attention. Anyone with a very restricted diet for any reason should be aware of scurvy risk. Older adults living alone who may have limited access to fresh food should also be mindful. This is less relevant for people eating a typical varied diet with fruits and vegetables.

According to this case, vitamin C supplementation led to rapid improvement in symptoms. Most people would expect to see noticeable improvement within days to weeks of starting treatment, though complete healing of bruising might take several weeks.

Want to Apply This Research?

  • Track daily fruit and vegetable servings to ensure adequate vitamin C intake. Set a goal of at least 2-3 servings daily and log what you eat. Also track any bruising, bleeding, or unusual symptoms to identify patterns.
  • Use the app to plan meals that include vitamin C-rich foods like oranges, strawberries, bell peppers, and broccoli. If you have dietary restrictions, use the app to find alternative sources of vitamin C or set reminders to take a vitamin C supplement daily.
  • Weekly review of fruit and vegetable intake to ensure consistency. Monthly check-in on any physical symptoms like unusual bruising or bleeding. If you have a chronic digestive condition, track how dietary changes affect your symptoms and energy levels.

This case report describes one patient’s experience with scurvy and should not be used for self-diagnosis. Unexplained bruising, bleeding, or leg pain can have many different causes and require professional medical evaluation. If you experience these symptoms, contact your healthcare provider immediately. Do not start or stop any supplements without consulting your doctor, especially if you take other medications. This information is educational and not a substitute for medical advice from a qualified healthcare professional.