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septic bursitis
Etiology:
1) trauma with direct transcutaneous inoculation of superficial bursa
2) organisms
a) Staphylococcus aureus (80%)
b) Streptococcus
c) gram negative organisms, fungi & mycobacteria are rarely involved
3) predisposing factors
a) diabetes mellitus
b) alcoholism
c) rheumatoid arthritis
d) gout
Clinical manifestations:
1) involvement of superficial bursae
a) prepatellar
b) infrapatellar
c) olecranon
2) pain & localized swelling
3) discrete bursal swelling with surrounding cellulitis
4) fever
5) maximal tenderness over the bursa
6) perservation of joint motion
Laboratory:
1) aspiration of bursal fluid
a) gram stain
b) culture
2) complete blood count (CBC)
Management:
1) drainage of bursa
- surgical drainage may be necessary
a) if bursal fluid cannot be drained by aspiration
b) if the patient is not responding to therapy
2) antibiotic therapy
a) cefazolin (Ancef) 0.5-1.5 g IV/IM 6-8 hr
b) cephalexin (Keflex) 500 mg PO QID
c) nafcillin 1-2 g IV every 4 hours
d) dicloxacillin 500 mg PO QID
Related
bursa
Specific
septic bursitis, ankle/foot
septic bursitis, elbow
septic bursitis, hip
septic bursitis, knee
septic bursitis, shoulder
General
bursitis
infection (infectious disease)
References
- Medical Knowledge Self Assessment Program (MKSAP) 11,19,
American College of Physicians, Philadelphia 1998, 2022
- Lormeau C, Cormier G, Sigaux J, et al.
Management of septic bursitis.
Joint Bone Spine. 2019;86(5):583-588.
PMID: 31615686