Bursitis Explained
Bursae are small, fluid-filled sacs located throughout the body, primarily near joints. These sacs act as cushions, reducing friction between bones, tendons, and muscles during movement. They facilitate smooth motion and prevent wear and tear on these structures.
General bursitis refers to the inflammation of these bursae. This condition often results from injury, repetitive motion, or overuse, leading to pain and swelling in the affected area. It can also stem from underlying inflammatory conditions like rheumatoid arthritis or gout.
While general bursitis involves inflammation, it is typically not caused by an infection. Septic bursitis, however, represents a more serious form where the bursa becomes infected by bacteria. This distinction is important, as an infection requires a different treatment approach and carries greater risks if untreated.
Causes and Risk Factors
Septic bursitis develops when bacteria gain entry into a bursa. This bacterial invasion commonly occurs through breaks in the skin, such as cuts, scrapes, insect bites, or puncture wounds located directly over a bursa. The bacteria can also spread to the bursa from an existing infection in nearby skin or tissues.
The most frequent bacterial culprit in septic bursitis is Staphylococcus aureus, often found on the skin. Other bacteria, including streptococci, can also cause the infection, though less commonly. Prompt wound care, such as cleaning and covering open skin lesions, helps reduce the risk of bacterial entry.
Certain factors increase an individual’s susceptibility to developing septic bursitis. People with weakened immune systems, due to conditions like HIV/AIDS or cancer, are more vulnerable. Chronic medical conditions, including diabetes, kidney disease, and chronic obstructive pulmonary disease (COPD), also elevate the risk. Furthermore, certain medications, such as corticosteroids, can suppress the immune response, making infections more likely. Alcoholism also contributes to a compromised immune system, increasing susceptibility.
Recognizing the Symptoms
Recognizing the symptoms of septic bursitis is important for timely medical intervention. The onset of symptoms is typically rapid and more severe compared to non-infectious bursitis. Individuals often experience intense pain that can worsen with movement or pressure on the affected area.
The skin over the infected bursa usually appears significantly red and feels warm to the touch. Pronounced swelling is also characteristic, often making the bursa feel full or tense. Tenderness upon palpation of the area is another common finding.
Beyond localized signs, systemic symptoms often accompany septic bursitis, indicating a broader infection. These can include fever, chills, and a general feeling of being unwell, known as malaise. The presence of these systemic symptoms, combined with the localized signs of inflammation, should prompt immediate medical evaluation.
Diagnosis and Treatment
Diagnosing septic bursitis typically begins with a thorough physical examination. A healthcare provider will inspect the affected joint for signs of redness, swelling, warmth, and tenderness. This initial assessment helps differentiate septic bursitis from other conditions that cause joint pain or inflammation.
A key diagnostic step involves aspirating fluid from the bursa, a procedure where a sterile needle is used to draw out a small sample of the bursal fluid. This fluid is then sent to a laboratory for analysis. Lab tests on the fluid include a white blood cell count, which will typically be elevated in an infection, and a Gram stain, which can identify the type of bacteria present. A culture of the fluid is also performed to definitively identify the specific bacteria causing the infection and determine its susceptibility to various antibiotics. Blood tests, such as a complete blood count (CBC) to check for elevated white blood cells and inflammatory markers like C-reactive protein (CRP), may also be conducted to assess the body’s overall inflammatory response.
Treatment for septic bursitis primarily involves antibiotics to combat the bacterial infection. Initially, broad-spectrum antibiotics are often prescribed, which target a wide range of bacteria, while awaiting the results of the fluid culture. Once the specific bacteria and its antibiotic sensitivities are known, the antibiotic regimen can be tailored for more effective treatment.
Drainage of the infected bursa, either through repeated aspiration or a small incision, is often necessary to remove pus and reduce pressure. Pain management strategies, including non-steroidal anti-inflammatory drugs (NSAIDs) or other pain relievers, are also an important part of treatment to alleviate discomfort. In severe cases, or when the infection is recurrent or does not respond to conservative measures, surgical intervention to remove the bursa (bursectomy) may be considered.
Preventive Measures
Preventive measures focus on protecting the skin and managing underlying health conditions. Proper wound care is a straightforward yet effective step in preventing bacterial entry. Any cuts, scrapes, or insect bites, particularly those over joints, should be thoroughly cleaned with soap and water and covered with a clean dressing. This creates a barrier against environmental bacteria.
Protecting joints from trauma or repetitive pressure also helps reduce the risk. Wearing protective padding during activities that involve kneeling or leaning on elbows, such as gardening or plumbing, can prevent skin breaks and direct injury to the bursae. Avoiding prolonged pressure on specific areas can also be beneficial.
Effectively managing chronic health conditions, such as diabetes, is important. Maintaining good control over blood sugar levels can help support a healthy immune system, making the body more resilient to infections. For individuals with compromised immune systems, extra vigilance in wound care and hygiene is advisable.
Seeking prompt medical attention for any suspicious symptoms, such as sudden redness, swelling, or pain around a joint, is crucial. Early diagnosis and treatment of potential infections can prevent septic bursitis from becoming more severe. This proactive approach helps ensure better outcomes and reduces the risk of complications.