Sverdrup et al used a diagnostic score to evaluate patients with erysipelas or necrotizing fasciitis. This can aid in making the diagnosis and monitoring response to therapy. The authors are from Karolinska Institute in Stockholm.
Parameters:
(1) effectiveness of oral antibiotics
(2) confusion
(3) circulatory shock
(4) fever > 38.5°C
(5) tenderness
(6) edema
(7) erythema
(8) purpura
(9) papules
(10) vesicles
(11) pustules
(12) bullae
(13) cyanosis
(14) pallor
(15) ulceration and necrosis
(16) lymphangitis
|
Parameter |
Finding |
Points |
|
effectiveness of oral antibiotics |
effective |
0 |
|
|
no effect |
3 |
|
confusion |
absent |
0 |
|
|
present |
5 |
|
circulatory shock |
absent |
0 |
|
|
present |
5 |
|
fever > 38.5°C |
none |
0 |
|
|
1 day |
0 |
|
|
2 to 3 days |
1 |
|
|
more than 3 days |
2 |
|
tenderness |
none |
0 |
|
|
present on touch |
1 |
|
|
present without touch |
5 |
|
edema |
none |
0 |
|
|
soft |
1 |
|
|
indurated |
5 |
|
erythema |
absent |
0 |
|
|
present |
1 |
|
purpura |
absent |
0 |
|
|
present |
1 |
|
papules |
absent |
0 |
|
|
present |
1 |
|
vesicles |
absent |
0 |
|
|
present |
1 |
|
pustules |
absent |
0 |
|
|
present |
1 |
|
bullae |
absent |
0 |
|
|
present |
5 |
|
cyanosis |
absent |
0 |
|
|
present |
5 |
|
pallor |
absent |
0 |
|
|
present |
5 |
|
ulceration and necrosis |
absent |
0 |
|
|
present |
5 |
|
lymphangitis |
absent |
2 |
|
|
present |
0 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 53 according to paper, 52 by my count
• maximum score for a patient with erysipelas: 15
• A patient with necrotizing fasciitis will have a score >= 18.
Specialty: Infectious Diseases, Surgery, general
ICD-10: ,
