emDocs- August 27, 2020 - By Pilcher C
"Takeaways:
- A simple ESR or CRP can assist in evaluating for SEA patients, especially in drug seekers and malingerers. The test is almost universally “shockingly elevated” (an ID colleague’s words) in SEA patients.
- Doing the test is evidence that one is thinking of SEA, and if normal, is an effective defense should one later be found.
- Those with a high ESR or CRP, risk factors, or a high level of suspicion should have a COMPLETE spine MRI, because the abscess is often found to be distant from the point of pain or be present at multiple levels.
- Missed SEA’s number in the dozens each year nationwide. Making the diagnosis in time to prevent disability could avoid tens of millions of dollars in settlements and years of stressful litigation. Hopefully no emDocs reader will ever miss one.
- The reference below is excellent but glosses over one of the major signs of SEA: frequent or escalating visits for back pain, even in chronic opioid users."