septic bursitis

Etiology

• trauma with direct transcutaneous inoculation of superficial bursa
• organisms
  • Staphylococcus aureus (80%)
  • Streptococcus
  • gram negative organisms, fungi & mycobacteria are rarely involved
• predisposing factors
  • diabetes mellitus
  • alcoholism
  • rheumatoid arthritis
  • gout

Clinical manifestations

• involvement of superficial bursae
  • prepatellar
  • infrapatellar
  • olecranon
• pain & localized swelling
• discrete bursal swelling with surrounding cellulitis
• fever
• maximal tenderness over the bursa
• perservation of joint motion

Laboratory

• aspiration of bursal fluid
  • gram stain
  • culture
• complete blood count (CBC)

Management

• drainage of bursa
  • surgical drainage may be necessary
  • if bursal fluid cannot be drained by aspiration
  • if the patient is not responding to therapy
• antibiotic therapy
  • cefazolin (Ancef) 0.5-1.5 g IV/IM 6-8 hr
  • cephalexin (Keflex) 500 mg PO QID
  • nafcillin 1-2 g IV every 4 hours
  • dicloxacillin 500 mg PO QID

More general terms

• bursitis
• infection (infectious disease)

More specific terms

• septic bursitis, ankle/foot
• septic bursitis, elbow
• septic bursitis, hip
• septic bursitis, knee
• septic bursitis, shoulder

Additional terms

• bursa