Mueller et al developed a score for evaluating a patient with cutaneous ulcers in a region with Mycobacterium ulcerans. The authors are from multiple hospitals in Cameroon, France and Switzerland.
Patient selection: skin ulcerations
Parameters:
(1) age
(2) gender
(3) smell (odor)
(4) yellow color
(5) green color
(6) undermning
(7) lesion hyposensitivity
(8) pain at rest
(9) diameter in centimeters
(10) locoregional lymphadenopathy
|
Parameter |
Findings |
Points |
|
age of the patient |
<= 20 years |
0 |
|
|
21 to 40 years |
-3 |
|
|
> 40 years |
-5 |
|
gender |
male |
0 |
|
|
female |
2 |
|
odor |
characteristic |
3 |
|
|
other |
0 |
|
yellow color |
absent |
0 |
|
|
present |
2 |
|
green color |
absent |
0 |
|
|
present |
1 |
|
underminng |
absent |
0 |
|
|
present |
1 |
|
hyposensitivity |
absent |
0 |
|
|
present |
1 |
|
pain at rest |
absent |
0 |
|
|
present |
-1 |
|
diameter |
<= 5 cm |
0 |
|
|
> 5 cm |
-1 |
|
locoregional lymphadenopathy |
absent |
0 |
|
|
present |
-2 |
where:
• More than one color may be present.
total score =
= SUM(points for all 10 parameters)
Interpretation:
• minimum score: -9
• maximum score: 10
• The higher the score the more likely that the lesion is a Buruli ulcer.
|
Total Score |
Interpretation |
|
< 0 |
consider alternative diagnosis |
|
0 to 3 |
perform PCR |
|
>= 4 |
treat as Buruli ulcer |
Performance:
• The area under the ROC curve was 0.86.
Specialty: Infectious Diseases
