Abstract. Upper extremity abscesses frequently present to the acute care setting with
inconclusive physical examination and imaging findings. We sought to
investigate the diagnostic accuracy of inflammatory markers including white
blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and C-reactive
protein (CRP). A retrospective cohort study was performed to identify
subjects ≥18 years treated with surgical
debridement of upper extremity abscesses at our institution between January 2012 and December 2015. In this study, 188 patients were screened, and
72 met the inclusion criteria. A confirmed abscess as defined by culture
positivity was present in 67 (93.1 %) cases. The sensitivity of WBC, ESR,
or CRP individually was 0.45, 0.71, and 0.81. The specificity of WBC, ESR, or
CRP individually was 0.80, 0.80, and 0.40. In combination all three markers
when positive had a sensitivity of 0.26 and specificity of 1.0. These values
were similar among patients with diabetes and those with obesity. With the
highest sensitivity and lowest specificity, CRP exhibited the most utility
as a screening test (level IV).
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