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September 08, 2023

What you should know about septic bursitis

Illness Joints

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Joint pain rarely requires emergency medical intervention. But if it’s caused by septic bursitis, prompt treatment is required. Here’s what you need to know about septic bursitis, including its causes, symptoms, and treatments.

Bursae and bursitis

Bursitis is the inflammation of a small, fluid-filled sac called a bursa. Bursae (the plural of bursa, which is pronounced bur-SEE) cushion and lubricate your joints so they can move smoothly and painlessly. You have more than 150 bursae in your body. The major ones are found near large joints, such as the ones in your shoulders, elbows, hips, and knees.

Each bursa has a thin outer membrane that produces a small amount of fluid to lubricate your joints. Sometimes, that membrane thickens and produces an excessive amount of fluid, causing the bursa to swell painfully. That’s bursitis.

Bursitis can be caused by overusing a joint, usually by repeatedly moving it in the same manner. Other causes of bursitis include injury, rheumatoid arthritis, gout, and infection. Bursitis caused by infection is called septic bursitis. Unless it’s promptly treated with antibiotics, the infection may spread into your blood, which can be life-threatening.

Septic bursitis causes

A bursa usually becomes infected when bacteria enter it through a skin injury, such as a scrape or cut. That’s why septic bursitis usually occurs in your knee or elbow where the bursae are close to your skin.

Infections also can spread to bursa from blood or nearby tissue. That’s one cause of septic bursitis in joints located between bone and muscle, such as the ones in your hips and shoulders.

Bursitis in deep bursae also can result from a previous medical procedure. That can be an operation; an injection of corticosteroids, which reduce inflammation; or an aspiration, in which a needle is used to remove fluid from a bursa or joint.

Risk factors

Septic bursitis happens more commonly in males. Fifty is the average age at which people first get it.

If you spend a lot of time engaging in occupational or recreational activities could injure your knees or elbows, you’re more likely than the average person to get septic bursitis.

Certain conditions also increase your risk of getting septic bursitis. They include diabetes, chronic obstructive pulmonary disease (COPD), and arthritis. Alcoholism and medicines that suppress your immune system, such as corticosteroids, also increase your risk of getting septic bursitis.

Symptoms and diagnosis

The symptoms of septic bursitis include swelling, stiffness, tenderness, and pain. You may also feel generally unwell and develop a fever.

The skin over the infected bursae may be red and warm to the touch. It also may show signs of an infection, such as a patchy appearance, a rash, bumps, and sores.

To make a diagnosis, health care providers generally begin by reviewing your medical history and giving you a physical exam, which will help them see if you’re showing signs of an infection.

They may also remove fluid from the affected bursa or bursae. This is usually performed with a needle, but sometimes requires a minor surgery instead.

Removing some of the fluid from the bursa or bursae should make you more comfortable. It also will allow your medical professional to see if:

• You have a high number of white blood cells, which indicates an infection.

 Your glucose levels are significantly lower than normal, which may indicate infection.

 There are crystals in your bursal fluid, which could suggest that you have gout and pseudogout.

 Certain infectious bacteria are present. To determine this, your medical professional will run a test called a gram stain.


If your doctor diagnoses you with septic bursitis, they very likely will prescribe antibiotics. The type and dose of antibiotic, as well as how long you should take it, will depend on your condition and the bacteria causing the infection.If the infection is advanced, or complications have developed, you may be given antibiotics intravenously.

Your medical professional also may remove more fluid, either through aspiration or by surgery. They also may remove the bursa or bursae, as new ones usually grow back in several months.

Most patients with septic bursitis have good outcomes. The key is detecting and treating it early. If you’re at risk for it, it’s important to familiarize yourself with the symptoms. If you begin experiencing any of those symptoms, see a medical professional as soon as you can.

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