I was actually able to do this using visionmedia/send (which handled a lot of my work with paths as well).
Here's the new code that works with seeking:
var send = require('send');
...
app.get('/stream/*', function(req, res) {
var path = Url.parse(req.url).pathname.replace('/stream','');
send(req, path)
.root(Config.media)
.on('error', function(err) {
res.statusCode = err.status || 500;
res.end(err.message);
})
.on('directory', function() {
res.statusCode = 403;
res.end("Forbidden");
})
.pipe(res);
});