NeBoP Score of Skogman et al for Evaluation of a Child with Lyme Neuroborreliosis

Description

Skogman et al reported the NeBoP score for recognition of a pediatric patient with neuroborreliosis in Europe. This can help to identify a patient who can be started on antibiotic therapy prior to completion of diagnostic testing. The authors are from Falun General Hospital, Dalama-Uppsala University and Linkoping University in Europe.

Patient: pediatric patient with suspected Lyme disease in Europe

Parameters on admission:

(1) acute cranial nerve palsy (facial nerve, other)

(2) fever (low grade at 38-39°C)

(3) fatigue

(4) erythema migrans and/or lymphocytoma (red-blue skin lesion on earlobe)

(5) pleocytosis in the CSF (>= 5 * 10^6/L and >= 90% mononuclear cells)

Parameter	Finding	Points
acute cranial nerve palsy	no	0
	yes	1
fever	no	0
	yes	1
fatigue	no	0
	yes	1
erythema migrans and/or lymphocytoma	no	0
	yes	1
pleocytosis in CSF	no	0
	yes	1

total score =

= SUM(points for the parameters)

Interpretation:

• minimum score: 0

• maximum score: 5

• A score >=3 indicates a high probability of neuroborreliosis and need for antibiotic therapy.

• If score 1 or 2 and erythema migrans or lymphocytoma present, then start antibiotic therapy for cutaneous Lyme disease.

Performance:

• The area under the ROC curve is 0.95 with diagnostic accuracy of 0.90.

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NeBoP Score of Skogman et al for Evaluation of a Child with Lyme Neuroborreliosis

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