# Scurvy Still Exists: A Case of Severe Vitamin C Deficiency With Functional Decline in the United States

## TL;DR

A 50-year-old woman in the U.S. was diagnosed with scurvy after initial misdiagnosis, showing the condition still occurs despite modern nutrition.

## Contribution

Highlights the ongoing relevance of scurvy diagnosis and the economic impact of delayed detection in developed nations.

## Key findings

- Scurvy cases persist in developed countries despite vitamin-fortified foods.
- Delayed diagnosis of scurvy leads to higher healthcare costs.
- Clinical signs and dietary assessment are crucial for early detection.

## Abstract

Scurvy remains a real, albeit underdiagnosed, condition in developed nations. Although most Western countries have introduced vitamin-fortified foods across nearly all supermarket categories, cases continue to occur and are frequently overlooked. Patients often undergo extensive and costly laboratory and imaging evaluations before the simple yet elusive diagnosis is established.

No formal U.S. analyses have quantified the total healthcare expenditures attributable to delayed diagnosis of scurvy. However, data from the Malnutrition Quality Improvement Initiative indicate that hospitals treating malnourished patients incur an average cost of USD 25,500 per admission, compared with approximately USD 12,500 for standard inpatient care.

We report the case of a 50-year-old woman presenting with profound weakness, anemia, and functional decline. Despite extensive prior evaluation, the diagnosis was initially missed. Careful physical examination and dietary assessment revealed clinical signs of vitamin C deficiency, subsequently confirmed by undetectable serum ascorbic acid levels. The patient improved rapidly following vitamin C supplementation. This case highlights the enduring importance of nutritional assessment and bedside examination in recognizing preventable diseases.