Bernardino V R, Mendes-Bastos Pedro, Noronha Carla, Henriques Celia Coelho
Department of Internal Medicine 2, Hospital Curry Cabral, Lisbon, Portugal.
BMJ Case Rep. 2012 Sep 17;2012:bcr0220125819. doi: 10.1136/bcr-02-2012-5819.
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.
作者报告了一例50岁慢性丙型肝炎病毒感染的酗酒男性病例，该患者因发热以及双下肢出现大量瘀斑和瘀点而就诊于急诊科。经过仔细检查和实验室评估，发现了不太明显的坏血病诊断。仅通过补充维生素C和给予营养建议，就观察到他的病情有了显著改善。在现代社会，由于普遍能够获取食物，坏血病已成为一种罕见疾病，常常被误诊。强调多学科方法是进行更简单鉴别诊断的关键，可避免不必要的检查，并防止严重并发症的发生，若不治疗甚至会导致死亡。
