Comparison of Nonseptic and Septic Bursitis Further Observations on the Treatment of Septic Bursitis

Ho, George

doi:10.1001/archinte.1979.03630480051017

Cited by 83 publications

(24 citation statements)

References 6 publications

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“…Differentiation was predominantly based on clinical presentation, blood chemistry and blood cultures, bursal aspirate, and bursal fluid culture. However, in the literature, clinical presentation (i.e., bursal swelling, redness, and tenderness) was not found to be suitable for differentiating between SB and NSB according to various studies [7,10,17,18]. Based on the evidence available, initial differentiation should be based on bursal temperature, bursal fluid analysis (white cell count, glucose, polymorphonuclear cell count), Gram staining, and gross aspirate characteristics [2,7,10,17,18], all of which were mentioned by less than 50 % of our Swiss colleagues.…”

Section: Discussionmentioning

confidence: 99%

“…[1] variables used to differentiate between SB and NSB, [2] difference in skin temperature between the affected and unaffected bursa, [3] intrabursal steroid injection is only indicated if NSB is verified by culture, [4] number chosen arbitrarily by the authors fluclaxacillin) or a first-generation cephalosporin (e.g., cefazolin) [1,3,4,7,10,17,20,26], unless Gram stain or other factors (e.g., allergies to antibiotics) suggest otherwise [22]. Considering that more than 95 % of bursitis pathogens are methicillin-sensitive cocci (S. aureus, streptococci), this coverage is certainly good, but it may be extensive.…”

Section: Diagmentioning

confidence: 99%

“…NSB is rarely caused by crystal deposition or systemic diseases, such as systemic lupus erythematosus, rheumatoid arthritis, or uremia [3,7,10].…”

mentioning

confidence: 99%

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Evaluation of current treatment regimens for prepatellar and olecranon bursitis in Switzerland

Baumbach

Wyen

Perez

et al. 2012

Eur J Trauma Emerg Surg

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Purpose Bursitis is a common entity. However, evidence for the best treatment procedures is lacking, with management concepts varying internationally. We evaluated current treatment regimens for septic (SB) and nonseptic (NSB) prepatellar (PB) and (OB) olecranon bursitis in Switzerland and compared them to the published literature. Methods A voluntary 23-item online survey was distributed amongst all registered Swiss infectiologists and orthopedic surgeons in December 2011. The literature comparison was based on a systematic literature review. Results Overall response rate was 14 % (n = 117); 11 % (n = 92) were included in the final analysis. The overwhelming majority (91 %) of the respondents differentiated between SB and NSB, with determination predominantly based on clinical presentation (83 %), blood chemistry (75 %), and bursal aspirate (66 %). NSB was predominantly treated conservatively via immobilization (78 %) and antiinflammatory medication (73 %). For SB, 85 % indicated surgical intervention, with 73 % prescribing concomitant antibiotics. Regarding antibiotic choice, 90 % used an aminopenicillin or its derivatives for a mean of 11 ± 5 days. The literature review revealed 66 relevant publications with an overall level of evidence of 2b, arguing for a conservative treatment approach in cases of SB or NSB. Conclusion Therapeutic regimens for OB/PB differed considerably within Switzerland. Surgical intervention and antibiotic treatment was the most common therapy for SB, whereas a conservative approach predominated for NSB, which contrasts with the international literature. Clearly, prospective multicenter and multidisciplinary studies are needed to identify an optimal and cost-saving approach to the treatment of these common clinical entities.

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Section: Discussionmentioning

confidence: 99%

Section: Diagmentioning

confidence: 99%

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Evaluation of current treatment regimens for prepatellar and olecranon bursitis in Switzerland

Baumbach

Wyen

Perez

et al. 2012

Eur J Trauma Emerg Surg

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“…[1][2][3][4] However, its incidence can be high in patients with frequently relapsing olecranon bursitis treated by repeated aspiration with or without intra-bursal drug injection, and/or repeated acupunctures. The two case reports herein are examples of such needle procedure-related septic bursitis complicating the contiguous olecranon erosion and/or osteomyelitis.…”

mentioning

confidence: 99%

Osteomyelitis Resulting from Chronic Septic Olecranon Bursitis: Report of Two Cases

Moon¹,

Kim

Park³

2016

Clinics in Shoulder and Elbow

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“…Sympathetic synovial effusions have probably been encountered by many clinicians. These effusions occur with several inflammatory processes, including rheumatoid arthritis, infection, and gout (2). However, those that are related to adjacent infectious processes are rarely reported.…”

mentioning

confidence: 99%

Sympathetic synovial effusions associated with septic arthritis and bursitis

Strickland

Raskin

Welton

1985

Arthritis & Rheumatism

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The term "sympathetic synovial effusion" refers to a transudative, noninflammatory effusion occurring in a synovial-lined space contiguous to another inflamed joint, bursa, or other tissue space, presumably occurring as a reactive phenomenon in response to the inflammation (1). Sympathetic effusions have received little attention in the rheumatoiogic literature, and a general discussion of their characteristics and natural history has been lacking. We present here a case report and discussion of sympathetic effusions associated with infectious arthritis and bursitis, and a review of the available literature.Case report. A 29-year-old white woman was admitted to the hospital, with fever and left knee swelling and pain, which she had had for 6 days.Medical history included hypertension and brittle insulin-dependent diabetes mellitus, complicated by nephropathy, retinopathy, and peripheral neuropathy. Pertinent findings from the physical examination included an oral temperature of 38°C. There was diffuse

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Comparison of Nonseptic and Septic Bursitis Further Observations on the Treatment of Septic Bursitis

Cited by 83 publications

References 6 publications

Evaluation of current treatment regimens for prepatellar and olecranon bursitis in Switzerland

Evaluation of current treatment regimens for prepatellar and olecranon bursitis in Switzerland

Osteomyelitis Resulting from Chronic Septic Olecranon Bursitis: Report of Two Cases

Sympathetic synovial effusions associated with septic arthritis and bursitis

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