TY - JOUR
T1 - Unusual Presentation of Pediatric Scurvy
T2 - A Necrotic Gastrostomy Tube Site in a 14-Year-Old Boy
AU - Zessis, Nicholas R.
AU - Peters, Sarah W.
AU - Samet, Jonathan D.
AU - Parzen-Johnson, Simon
AU - Russo, Laura T.
AU - Samady, Waheeda
AU - Stephen, Rebecca
N1 - Publisher Copyright:
© Am J Case Rep, 2023.
PY - 2023
Y1 - 2023
N2 - Background: Case Report: Conclusions: Despite being considered a disease of the past, pediatric scurvy is increasingly reported in developed countries, especially among children with autism spectrum disorder, developmental delays, or a restrictive diet. Pediatric patients typically present with lower extremity pain or refusal to walk. This case study features an atypical presentation of scurvy in a non-ambulatory patient. A 14-year-old boy with arthrogryposis multiplex congenita displayed a late-stage scurvy symptom: a necrotic gastrostomy tube site, indicative of poor wound healing due to vitamin C deficiency. The usual telltale symptoms of scurvy were camouflaged due to his non-ambulatory status, which may have contributed to a delayed presentation. Nevertheless, a comprehensive clinical evaluation, incorporating diet history, gingival symptoms, petechiae, and characteristic radiological signs, eventually led to the correct diagnosis. Although acute osteomyelitis was initially suspected, it was subsequently ruled out. Upon initiation of vitamin C therapy, the patient’s symptoms subsided within a few days, and the necrotic tissue surrounding the gastrostomy tube healed completely within two weeks. The highlighted case underscores the importance of including scurvy in the differential diagnosis for pediatric patients with lower extremity pain without fever. A detailed dietary history focusing on vitamin C intake is crucial during clinical evaluation. Early initiation of vitamin C therapy, when scurvy is suspected, may prevent unnecessary and extensive diagnostic workup for other potential causes, offering timely relief to the patient.
AB - Background: Case Report: Conclusions: Despite being considered a disease of the past, pediatric scurvy is increasingly reported in developed countries, especially among children with autism spectrum disorder, developmental delays, or a restrictive diet. Pediatric patients typically present with lower extremity pain or refusal to walk. This case study features an atypical presentation of scurvy in a non-ambulatory patient. A 14-year-old boy with arthrogryposis multiplex congenita displayed a late-stage scurvy symptom: a necrotic gastrostomy tube site, indicative of poor wound healing due to vitamin C deficiency. The usual telltale symptoms of scurvy were camouflaged due to his non-ambulatory status, which may have contributed to a delayed presentation. Nevertheless, a comprehensive clinical evaluation, incorporating diet history, gingival symptoms, petechiae, and characteristic radiological signs, eventually led to the correct diagnosis. Although acute osteomyelitis was initially suspected, it was subsequently ruled out. Upon initiation of vitamin C therapy, the patient’s symptoms subsided within a few days, and the necrotic tissue surrounding the gastrostomy tube healed completely within two weeks. The highlighted case underscores the importance of including scurvy in the differential diagnosis for pediatric patients with lower extremity pain without fever. A detailed dietary history focusing on vitamin C intake is crucial during clinical evaluation. Early initiation of vitamin C therapy, when scurvy is suspected, may prevent unnecessary and extensive diagnostic workup for other potential causes, offering timely relief to the patient.
KW - Arthrogryposis Multiplex Congenita Neurogenic Type
KW - Osteomyelitis
KW - Scurvy
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U2 - 10.12659/AJCR.940770
DO - 10.12659/AJCR.940770
M3 - Article
C2 - 37464734
AN - SCOPUS:85165356320
SN - 1941-5923
VL - 24
JO - American Journal of Case Reports
JF - American Journal of Case Reports
M1 - e940770
ER -