Septic bursitis

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Information about Septic bursitis
Health & Medicine

Published on October 29, 2014

Author: nngowen



Internal Medicine

1. Septic Bursitis INTERN MORNING REPORT 10/22/14

2. Etiology and Pathogenesis 150 bursae in the human body Bacterial inoculation, spread from soft tissue, or hematogenous Superficial bursae – direct inoculation or contiguous spread ◦ Separate skin from deeper tissues Prepatellar or infrapatellar – athletes or those with kneeling occupations Predisposing factors – amount of bursal fluid, loss of skin integrity, impaired immune response

3. Presentation Pain and peribursal erythema and warmth, often in setting of DM, EtOHism, or immune supression Fever, peribursal edema and pain on movement Adjacent joint motion intact compared to septic arthritis Leukocytosis, elevated ESR and CRP

4. Diagnosis History of trauma not helpful Marked warmth and erythema Puncture wound or abrasion Aspiration of fluid – when effusion is present Cell count, gram stain, and culture Ddx: cellulitis, crystal induced, acute monoarthritis, osteo

5. Treatment Antibiotics and drainage 80% staph aureus, strep also common Inflammation if gram stain is negative Mild- dicloxacillin, clinda, doxy Severe – vanc , then cefazolin Duration of therapy 3-4 weeks, aspirate until bursal fluid sterile or no longer accumulates

6. Sources

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