Light-headedness and a petechial rash
Were this patient’s complaints of worsening light-headedness, rash, and bruising related to his history of alcohol abuse?
Treat with ascorbic acid
Patients with scurvy will need to be treated with a repletion dose of ascorbic acid 100 mg 3 times a day1 (strength of recommendation: A). Manifestations of scurvy recede quickly and usually disappear within a few weeks. Subjective improvement commonly occurs within 24 hours.1
Educating our patient
Given the severity of our patient’s case, he was told that he needed to take 1500 mg ascorbic acid daily. He also received information on alcohol abuse treatment and was counseled on proper nutrition. He was advised to maintain a balanced diet that included the recommended daily amount of all essential vitamins.
Within 48 hours, his hemoglobin stabilized.
CORRESPONDENCE
Sean Robinson, MD, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, FM, Portland, OR 97239; robinsse@ohsu.edu
