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Comment by raducu | Hacker News Reader

My wife did receive a CRP test that confirmed her infection in the hospital(it was over 200) -- that was among the first things the emergency department checked, then an ultrasound revealed the burst apendice, but I don't think there's any easy way to check it at home.

She already had a lot of burst veins from the hospital, so we decided to just do what her surgeon said, basically take amoxicillin for another 7 days and just about it.

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CRP can’t really confirm an infection. It’s a marker of inflammation. Inflammation often correlates with infection but not always. Can be lots of other things too, including a lot of the things that are false positives on these sepsis algos.

Ultimately doctors have to take the whole clinical picture into account instead of relying on a couple markers or vital signs.

You’re right that a big problem is the inability of our system to do testing at home, which might greatly expand the scope of the clinical picture. But it still wouldn’t be a cure-all

You have to compare to the current situation where we are overreliant on fever as a marker. If after an operation, your CRP levels shoot high unexpectedly, wouldn't you want to know and start investigating what's going on?

You should instead be doing a WBC count with a breakdown of neutrophils and other leukocytes, not a CRP which is highly non-specific

You should be doing both. WCC and neutrophils can also be misleading, and tend to fluctuate. Procalcitonin can be helpful in some situations but isn’t used as often.

I think what you are assuming is that early intervention in infection is good. Very likely to be true. And that we can reliably detect early infection. Much less likely to be true.

The biggest issue is the costs of false positives, which with any early intervention protocol are likely to be high and, questionably, on balance a net negative.

CRP normally does shoot up post operatively, and white cell count behaves similarly. Generally if there is a post op problem people know- maybe not a fever but people feel generally unwell. That is a good reason to investigate further. Sometimes for higher risk operations we do routine blood tests as an inpatient, but if people are will enough to go home, it’s reasonable to rely on people not feeling right.

A nurse can take a CRP quick test. Home test kits are available to order as well, but I haven't tried them.

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