Evaluating the utility of inflammatory markers in the diagnosis of soft tissue abscesses of the forearm and hand

Abstract

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).

Construction of a Multi-Indicator Model for Abscess Prediction in Granulomatous Lobular Mastitis Using Inflammatory Indicators

“…22 Studies have shown that N and ESR are risk factors for the development of pyogenic spondylodiscitis (PS), soft tissue abscesses of the forearm and hand, and intra-abdominal abscesses (IA), which promotes abscess formation and improves the positive predictive values (PPV) in patients. [23][24][25] Yildirim et al reported significantly elevated levels of neutrophil to lymphocyte ratio(NLR) in tubo-ovarian abscesses, with an NLR value >4.15 having a sensitivity of 95.2% and a specificity of 99.4% for diagnosing tubo-ovarian abscesses. 26 GLM with erythema nodosum often suggests a more aggressive disease, characterised by the appearance of slightly red, tender nodules on the lower legs.…”