The Symptom-History-Urine Dipstick (SHU) score of Dobbs and Fleming can be used to evaluate a patient for a urinary tract infection (UTI). The authors are from Birmingham.
Patient selection: pediatric, nonpregnant female
SHU findings:
(1) frequency
(2) nocturia
(3) dysuria
(4) urgency
(5) hematuria
(6) offensive urine
(7) nausea
(8) symptoms for <= 9 days
(9) history of previous UTI
(10) history of previous IVP (intravenous pyelography)
(11) dipstick positive for protein
(12) dipstick positive for blood
(13) dipstick positive for nitrite
Pediatric patient 0 to 14 years
|
Present |
Absent |
frequency |
2 |
-2 |
nocturia |
0 |
0 |
dysuria |
3 |
-3 |
urgency |
0 |
0 |
hematuria |
0 |
0 |
offensive urine |
2 |
0 |
nausea |
-2 |
0 |
symptoms <= 9 days |
1 |
-3 |
history previous UTI |
2 |
-1 |
history previous IVP |
2 |
0 |
dipstick positive protein |
5 |
-2 |
dipstick positive blood |
4 |
-1 |
dispstick positive nitrite |
4 |
-1 |
Female 15 to 49 years, nonpregnant
|
Present |
Absent |
frequency |
1 |
-3 |
nocturia |
2 |
-2 |
dysuria |
2 |
-2 |
urgency |
1 |
-1 |
hematuria |
3 |
0 |
offensive urine |
2 |
0 |
nausea |
-2 |
0 |
symptoms <= 9 days |
1 |
-3 |
history previous UTI |
0 |
0 |
history previous IVP |
2 |
0 |
dipstick positive protein |
3 |
-1 |
dipstick positive blood |
3 |
-3 |
dispstick positive nitrite |
11 |
-2 |
Female >= 50 years, nonpregnant
|
Present |
Absent |
frequency |
1 |
-3 |
nocturia |
2 |
-4 |
dysuria |
2 |
-2 |
urgency |
1 |
-1 |
hematuria |
0 |
0 |
offensive urine |
2 |
-1 |
nausea |
-2 |
0 |
symptoms <= 9 days |
0 |
0 |
history previous UTI |
1 |
-2 |
history previous IVP |
2 |
0 |
dipstick positive protein |
0 |
0 |
dipstick positive blood |
1 |
-2 |
dispstick positive nitrite |
5 |
-2 |
score =
= SUM(points for all of the parameters)
Interpretation:
• A high positive score is associated with UTI.
• A negative score is seen in patients negative for UTI.
• A patient with a UTI can have a negative score and a patient with a positive score may be negative for UTI.
Specialty: Infectious Diseases, Urology