Acute-Phase Reactants in Operatively Treated Upper Extremity Infections: A Retrospective Review

Area of Science:

• Infectious Diseases
• Orthopedic Surgery
• Clinical Pathology

Background:

• Limited data exist on acute-phase markers for upper extremity infections.
• Diagnosis often relies on clinical assessment and laboratory markers.
• Identifying sensitive diagnostic markers is crucial for timely intervention.

Purpose of the Study:

• To evaluate the diagnostic utility of white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) in upper extremity infections.
• To determine the sensitivity of these markers in patients requiring operative debridement.
• To compare the effectiveness of CRP, ESR, and WBC in detecting culture-positive infections.

Main Methods:

• Retrospective review of 61 patients with upper extremity infections over 12 years.
• Inclusion criteria focused on infections necessitating operative debridement.
• Analysis of laboratory results including WBC count, ESR, and CRP levels.

Main Results:

• C-reactive protein (CRP) demonstrated the highest sensitivity for detecting culture-positive infections (90% abnormal).
• White blood cell (WBC) count and erythrocyte sedimentation rate (ESR) showed lower sensitivity (54% and 67% abnormal, respectively).
• CRP sensitivity was significantly higher than ESR and WBC (P < .001, P < .0001).

Conclusions:

• C-reactive protein (CRP) is the most sensitive laboratory marker for upper extremity infections requiring debridement.
• White blood cell (WBC) count and erythrocyte sedimentation rate (ESR) can be normal despite infection and should be interpreted cautiously.
• CRP is a valuable tool in the diagnostic workup of these infections.