Difference between revisions of "Septic bursitis"
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==Background== | ==Background== | ||
*Most common sites are prepatellar bursa and olecranon bursa | *Most common sites are prepatellar bursa and olecranon bursa | ||
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==Clinical Features== | ==Clinical Features== | ||
*Acute pain, tenderness, warmth, and erythema of affected bursa | *Acute pain, tenderness, warmth, and erythema of affected bursa | ||
**None of which is seen in aseptic bursitis | **None of which is seen in aseptic bursitis | ||
*Fever (<50%) | *Fever (<50%) | ||
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| + | ==Differential Diagnosis== | ||
| + | *[[Olecranon bursitis (nonseptic)]] | ||
| + | *[[Prepatellar bursitis (nonseptic)]] | ||
==Diagnosis== | ==Diagnosis== | ||
*Bursal fluid aspiration | *Bursal fluid aspiration | ||
**Both diagnostic and therapeutic | **Both diagnostic and therapeutic | ||
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==Treatment== | ==Treatment== | ||
Revision as of 00:36, 7 April 2015
Contents
Background
- Most common sites are prepatellar bursa and olecranon bursa
Clinical Features
- Acute pain, tenderness, warmth, and erythema of affected bursa
- None of which is seen in aseptic bursitis
- Fever (<50%)
Differential Diagnosis
Diagnosis
- Bursal fluid aspiration
- Both diagnostic and therapeutic
Treatment
Antibiotics
Cover Staphylococcus aureus (80-90%) and Streptococcus
Outpatient Options
- Clindamycin 300 mg PO three times daily x 14 days OR
- TMP/SMX 2 DS tabs PO two times daily x 14 days OR
- Dicloxacillin 500mg PO q6hr x10 days
Treatment followup with primary physician is important since the regimen may need extension to 3 weeks.
Inpatient Options
- Vancomycin 25-30 mg/kg IV loading then 15-20 mg/kg IV OR
- Clindamycin 600 mg (10/mg/kg) IV three times daily
- Linezolid 600 mg IV BID (10mg/kg Q8hrs for pediatrics)
Disposition
- Consider admission for:
- Extensive purulent bursitis
- Extensive surrounding cellulitis
- Suspected joint involvement
- Immunocompromise
- Failure to resopnd to course of PO abx
See Also
Source
- Tintinalli