Difference between revisions of "Septic bursitis"

(Text replacement - "==Treatment==" to "==Management==")
(Disposition)
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**Suspected joint involvement
 
**Suspected joint involvement
 
**Immunocompromise
 
**Immunocompromise
**Failure to resopnd to course of PO abx
+
**Failure to resopnd to course of PO antibiotics
  
 
==See Also==
 
==See Also==

Revision as of 01:06, 14 July 2016

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

Management

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 antibiotics

See Also

References