You are correct. Scurvy, which results from vitamin C (ascorbic acid) deficiency was confirmed by dermatology. Vitamin C is used in the synthesis of collagen and neurotransmitters, and helps in dietary iron absorption. Deficiency results in poor wound healing, defective capillary walls, and anemia. S/sx of scurvy include lethargy, purpura, epistaxis, myalgia, dyspnea, spongy gums, and tooth loss. Complications include hemorrhage, neuropathies, immunocompromise, and hepatic and renal failure. The pt was started on ascorbic acid (400 mg/day) and initially improved, but died later of a nosocomial infection.

You are correct. Upper endoscopy showed multiple Ascaris lumbricoides (A) and Ancylostoma duodenale (B) in the upper duodenum. The antiperistaltic migration of these helminths had resulted in dysphagia. The patient’s symptoms resolved after tx w/ albendazole.