An unusual presentation of scurvy following head injury

We report an unusual clinical presentation of scurvy in a one and half year old child. The child presented with abrupt onset of peri-orbital ecchymoses and scalp hemorrhage following head injury. The child also had a history of temper tantrums and head banging. Our case did not have any of the typical clinical features of scurvy. The diagnosis was eventually confirmed radiologically and by observing a dramatic response to vitamin C therapy. It is important to remember that scurvy can present atypically i.e. without bleeding gums, painful limbs, pseudo-paralysis or scorbutic rosary. Scurvy should be kept as a differential diagnosis in a young child presenting with bleeding manifestations. Taking a detailed dietary history is of utmost importance in pediatric practice.