Septic bursitis: Difference between revisions

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==Treatment==
==Treatment==
*[[Antibiotics]]
===[[Antibiotics]]===
**Cover staph/strep (including [[MRSA]])
{{Septic Bursitis Antibiotics}}
**[[Clindamycin]] 300mg TID x10d OR [[dicloxacillin]] 500mg q6hr x10d
*Drainage
**[[Incision and Drainage]] vs. serial needle drainage


==Disposition==
==Disposition==

Revision as of 18:01, 6 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%)

Diagnosis

  • Bursal fluid aspiration
    • Both diagnostic and therapeutic

Differential Diagnosis

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