M: Migration of pain to RLQ Periumbilical or epigastric pain that has migrated to the right lower quadrant.
Loss of appetite during the current illness.
Either nausea or vomiting (or both) during the current episode.
Direct palpable tenderness in the right lower quadrant on examination — worth 2 points.
Pain on release of pressure over the RLQ (rebound tenderness).
E: Elevated temperature ≥ 37.3 °C Measured temperature ≥ 37.3 °C / 99.1 °F.
L: Leukocytosis WBC > 10,000/µL WBC count above 10,000/µL on CBC — worth 2 points.
S: Shift to left (neutrophilia > 75%) Neutrophil predominance > 75% on the differential.