Diagnostic accuracy of C-reactive protein and erythrocyte sedimentation rate in patients with acute scrotum

ABSTRACT

Our aim was to investigate the diagnostic efficacy of C-reactive protein [CRP] and erythrocyte sedimentation rate [ESR] in patients with acute scrotum. One hundred and twenty patients with an acute scrotum were evaluated and assigned into 3 groups 46 had acute epididymitis [group 1], 23 had spermatic cord torsion [group 2], and 51 had other noninflammatory causes of acute scrotum. Serum samples of all patients taken at the time of admission were tested for CRP levels and ESR. An at least 4-fold increase in the serum CRP levels was seen in 44 patients [95.6%] in group 1 [mean, 67.77 +/- 47.80 mg/L]. In contrast, only 1 patient in group 2 had a significant increase in serum CRP level [mean, 9.0 +/- 4.90 mg/L]. The patients in group 3 did not experience any significant increase of CRP levels [mean, 7.0 +/- 2.2 mg/L]. The patients with epididymitis had higher CRP and ESR values than others [P <.001; P <.001]. The best cutoffs were 24 mg/L for CRP and 15.5 mm/h for ESR to differentiate between epididymitis and noninflammatory causes of acute scrotum. The sensitivity and specificity were 93.4% and 100% for CRP and 95.6% and 85.1% for ESR, respectively. Based on our findings, serum levels of CRP and ESR can provide helpful information easily and rapidly for differentiation between epididymitis and other causes of acute scrotum. We suggest CRP and ESR be measured before making a decision of surgical exploration