Infected bursitis: signs, treatment and when to seek care

Clinicians also call this septic bursitis. It commonly affects bursae close to the skin, where bacteria may enter through a cut, graze, puncture or nearby skin infection.

Both infected and non-infected bursitis can cause tenderness and swelling. Infection is more concerning when the skin is distinctly warm or red, pain is worsening, fluid drains from the area, or fever and chills accompany the local symptoms. A clinician cannot always tell the cause from appearance alone.

Assessment may include examining the skin and joint movement. Joint aspiration may be used to remove a sample of bursal fluid for laboratory testing. The result can help distinguish infection from irritation, gout or another inflammatory problem.

Arrange prompt clinical assessment rather than treating suspected infection with rest alone. Keep any broken skin clean and covered, avoid squeezing or piercing the swelling, and reduce pressure on the affected area while awaiting care.

Treatment may involve antibiotics and drainage of excess fluid. Anti-inflammatory medicine can ease discomfort for some people, but it does not eliminate bacteria. Cortisone injection is generally avoided when infection is present or has not been excluded because steroid medicine can suppress the local immune response.

Seek urgent medical care for rapidly spreading redness, severe or quickly increasing pain, pus, fever, chills, confusion, faintness, or feeling markedly unwell. Prompt care is also warranted when redness tracks away from the swelling or movement becomes suddenly difficult.

Tell the clinician about recent wounds, injections, surgery, immune-suppressing medicines, diabetes, previous gout and any antibiotics already taken. These details can change the tests and treatment selected.

Ask whether fluid sampling is needed, what changes should trigger emergency care, how to protect the area, and when normal activity can resume. If antibiotics are prescribed, clarify how to take them and what to do if symptoms worsen or side effects develop.