Difference between revisions of "Septic bursitis"

(Treatment)
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==Background==
 
==Background==
 
*Most common sites are prepatellar bursa and olecranon bursa
 
*Most common sites are prepatellar bursa and olecranon bursa
 +
 
==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%)
 +
 +
==Differential Diagnosis==
 +
*[[Olecranon bursitis (nonseptic)]]
 +
*[[Prepatellar bursitis (nonseptic)]]
  
 
==Diagnosis==
 
==Diagnosis==
 
*Bursal fluid aspiration
 
*Bursal fluid aspiration
 
**Both diagnostic and therapeutic
 
**Both diagnostic and therapeutic
 
==Differential Diagnosis==
 
*[[Olecranon bursitis (nonseptic)]]
 
*[[Prepatellar bursitis (nonseptic)]]
 
  
 
==Treatment==
 
==Treatment==

Revision as of 00:36, 7 April 2015

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

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