Vazquez et al used a clinical severity score to evaluate varicella (chickenpox) in children. This is a modification of Gershon et al. It can be used to determine the effectiveness of varicella vaccine in pediatric populations.
Parameters for score:
(1) number of lesions
(2) character of lesions
(3) fever
(4) systemic signs (pain in the back or abdomen, interstitial pneumonia, encephalitis)
(5) clinical appearance, as a subjective assessment by clinician
|
Parameter |
Finding |
Points |
|
number of lesions |
1 – 50 |
1 |
|
|
51 – 100 |
2 |
|
|
101 – 500 |
4 |
|
|
>= 501 |
6 |
|
character of lesions |
macular |
2 |
|
|
papular |
2 |
|
|
mostly vesicular |
4 |
|
|
hemorrhagic |
4 |
|
fever |
temperature < 38.8°C |
0 |
|
|
temperature 38.8 – 39.9°C (102 – 103.9°F) |
1 |
|
|
temperature >= 40°C (104°F) |
3 |
|
pain in the back or abdomen |
absent |
0 |
|
|
present |
4 |
|
interstitial pneumonia |
absent |
0 |
|
|
present |
5 |
|
encephalitis |
absent |
0 |
|
|
present |
5 |
|
clinical appearance |
does not appear ill, or mildly ill |
0 |
|
|
appears moderately ill |
2 |
|
|
appears severely ill |
5 |
after Table 1, page 956.
where:
• I assume that there is at least 1 lesion present.
• I assume that the lesion must have one of the 4 characters.
• An alternative to score the systemic signs is to score only the maximal finding of the 3.
• For clinical appearance, I added "or mildly ill", which was not in the original table.
clinical severity score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: may be 3 (assume 1 lesion that is macular or papular)
• maximum score: may be 32 (based on assumptions above)
|
Score |
Disease Severity |
|
<= 7 |
mild |
|
8 – 15 |
moderate |
|
>= 16 |
severe |
Specialty: Infectious Diseases
ICD-10: ,
