Published on October 29, 2014
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 www.uptodate.com
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1. Semin Arthritis Rheum. 1995 Jun;24(6):391-410. Septic bursitis. Zimmermann B 3rd(1), Mikolich DJ, Ho G Jr. Author information: (1 ...
Septic Bursitis: Symptoms Incidence, Prevalence & Riskfactors Laboratory, Imaging & ECG Complications and Differential diagnoses on Symptoma®, the ...
Most patients with bursitis are treated conservatively to reduce inflammation. Conservative treatment includes rest, cold and heat treatments ...
1. J Emerg Med. 2009 Oct;37(3):269-72. Epub 2007 Jul 20. Septic bursitis: a case report and primer for the emergency clinician. Wasserman AR(1), Melville ...