Septic bursitis: Difference between revisions
ClaireLewis (talk | contribs) |
Neil.m.young (talk | contribs) (Text replacement - "==Diagnosis==" to "==Evaluation==") |
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*[[Prepatellar bursitis (nonseptic)]] | *[[Prepatellar bursitis (nonseptic)]] | ||
== | ==Evaluation== | ||
*Bursal fluid aspiration | *Bursal fluid aspiration | ||
**Both diagnostic and therapeutic | **Both diagnostic and therapeutic | ||
Revision as of 16:42, 25 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
Evaluation
- Bursal fluid aspiration
- Both diagnostic and therapeutic
Management
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 IV three times daily
- Linezolid 600 mg IV BID
- Clindamycin 10mg/kg IV three times daily
- Linezolid 10mg/kg Q8hrs
Disposition
- Consider admission for:
- Extensive purulent bursitis
- Extensive surrounding cellulitis
- Suspected joint involvement
- Immunocompromise
- Failure to resopnd to course of PO antibiotics