Ibrahim et al reported the ASSET score for evaluating a pediatric patient with cellulitis. This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Melbourne and the Royal Children's Hospital in Australia.
Patient selection: 6 months to 18 years
Parameters:
(1) area (A) as percent of body surface area (BSA)
(2) systemic features (S)
(3) swelling (S)
(4) eye (E)
(5) tenderness (T)
Parameter
Finding
Points
area involved
< 1% body surface area
0
>= 1% of BSA
1
systemic features
none
0
present
1
swelling
none
0
mild
1
moderate to severe
2
eye
not involved
0
involved
1
tenderness
none
0
mild
1
moderate to severe
2
where:
• The area of the child's outstretched hand is about 1% of BSA.
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
• A score >= 4 is an indication for intravenous antibiotics.
• A score <= 3 is an indication for oral antibiotics.
Performance:
• The area under the ROC curve is 0.86.
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