Septic bursitis occurs when the bursa, or the sac of fluid found in the small space in between the bones and muscles to help provide a cushioning surface, becomes inflamed due to infection. Septic bursitis can be caused by underlying skin and blood infections, and is more likely to affect those who frequently experience non-infectious inflammatory bursitis.
Causes of Septic Bursitis
Septic bursitis occurs when microorganisms are introduced into the bloodstream through injury or other illness. Streptococci or staphylococci may be present in the bloodstream and may also infect the bursa following an injury. Cellulitis and septic arthritis may also cause septic bursitis.
Symptoms of Septic Bursitis
Like other forms of bursitis, septic bursitis will often present as tender or painful swelling in the area. However, physicians are often able to differentiate septic bursitis from other kinds of bursitis if the swelling feels warm to the touch and if the patient presents with a fever. There may be erythema or redness of the skin in the event this condition is present as well. Illnesses that affect blood circulation, such as diabetes, can make a patient more susceptible to these infections. Patients who take steroid medication may be more susceptible as well, because of the medication’s tendency to weaken the immune system.
Diagnosis of Septic Bursitis
A diagnosis of septic bursitis is often preceded by a diagnosis of non-infectious bursitis, which can be diagnosed by observation and palpation of the swelling. Imaging and diagnostic tests can sometimes be used for diagnosis if the bursitis frequently recurs. Physicians may diagnose septic bursitis after discovering the patient is experiencing the symptoms of the condition enumerated above. If the patient has another condition that may make him more vulnerable to this kind of bursitis, such as cellulitis, physicians may be more likely to diagnose septic bursitis.
Treatment of Septic Bursitis
Unlike other kinds of bursitis, septic bursitis will not respond to rest or icing the area. The infection must be eliminated, which usually calls for treatment with antibiotics. On occasion, these will need to be injected intravenously. The infected fluid has to be aspirated as well, often in repeated procedures to make sure the infection has gone.
Quote: “Although septic bursitis is not diagnosed based on clinical signs alone, certain signs that favor the diagnosis of septic over sterile inflammatory bursitis include bursal tenderness/erythema, bursal warmth, peribursal cellulitis, and fever.”
Source: Eileen Chang, MD, Attending, Department of Emergency Medicine, North Shore Medical Center (eMedicine.Medscape.com)
Quote: “For example, with bursitis over the elbow, there is often obvious swelling, the flesh is soft, and it feels like there’s fluid inside.”
Source: Morris B. Mellion, M.D., clinical associate professor at the University of Nebraska Medical Center