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Clinical characteristics and outcomes of septic bursitis

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Abstract

Purpose

Limited data guide practice in evaluation and treatment of septic bursitis. We aimed to characterize clinical characteristics, microbiology, and outcomes of patients with septic bursitis stratified by bursal involvement, presence of trauma, and management type.

Methods

We conducted a retrospective cohort study of adult patients admitted to a single center from 1998 to 2015 with culture-proven olecranon and patellar septic bursitis. Baseline characteristics, clinical features, microbial profiles, operative interventions, hospitalization lengths, and 60-day readmission rates were determined. Patients were stratified by bursitis site, presence or absence of trauma, and operative or non-operative management.

Results

Of 44 cases of septic bursitis, patients with olecranon and patellar bursitis were similar with respect to age, male predominance, and frequency of bursal trauma; patients managed operatively were younger (p = 0.05). Clinical features at presentation and comorbidities were similar despite bursitis site, history of trauma, or management. The most common organism isolated from bursal fluid was Staphylococcus aureus. Patients managed operatively were discharged to rehabilitation less frequently (p = 0.04).

Conclusions

This study of septic bursitis is among the largest reported. We were unable to identify presenting clinical features that differentiated patients treated surgically from those treated conservatively. There was no clear relationship between preceding trauma or bursitis site and clinical course, management, or outcomes. Patients with bursitis treated surgically were younger. Additional study is needed to identify patients who would benefit from early surgical intervention for septic bursitis.

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Authors and Affiliations

  1. Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA

    Sarah B. Lieber

  2. Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA

    Mary Louise Fowler & Clara Zhu

  3. Cambridge Health Alliance, 1493 Cambridge Street, Cambridge, MA, 02139, USA

    Andrew Moore

  4. Division of Rheumatology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street, Suite 4B, Boston, MA, 02215, USA

    Robert H. Shmerling & Ziv Paz

Authors
  1. Sarah B. Lieber
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  2. Mary Louise Fowler
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  3. Clara Zhu
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  4. Andrew Moore
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  5. Robert H. Shmerling
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  6. Ziv Paz
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Corresponding author

Correspondence to Sarah B. Lieber.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Lieber, S.B., Fowler, M.L., Zhu, C. et al. Clinical characteristics and outcomes of septic bursitis. Infection 45, 781–786 (2017). https://doi.org/10.1007/s15010-017-1030-3

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  • DOI: https://doi.org/10.1007/s15010-017-1030-3

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