Scoring of urinary findings as an aid in diagnosis for childhood urinary tract infection.

To improve diagnostic accuracy of urinary tract infection in infants and children a simple score is described. 213 patients with suspect urinary tract infection underwent a diagnostic work-up including 2 consecutive clean-voided urine samples, and a suprapubic bladder aspirate as a diagnostic reference. The uncentrifuged clean-voided urine specimens were scored separately for microscopic leucocyte and bacterial count as well as for quantitative bacterial culture. The scores obtained were added together and a diagnostic scheme was created. After this scheme had been tested in 50 consecutive symptomatic urinary tract infections, it was possible to start therapy in 48 patients following the microscopic examination of 2 consecutive clean-voided urine samples from each. Likewise, 44 of 50 asymptomatic urinary tract infections were diagnosed by this scheme, after the urine cultures had been obtained. The scheme may be a useful aid in diagnosing urinary tract infection in infants and children, in case of equivocal urinary findings in particular.