Septic bursitis: symptoms and next steps

It often affects a bursa close to the skin, especially near the elbow or kneecap. The area may become painful, warm, red and swollen; fever or feeling unwell can occur but may be absent.

Bacteria can enter through a small cut, graze, puncture or nearby skin infection. Risk may also be higher when immune defences are reduced. Septic and non-infectious bursitis can look alike, so appearance alone may not settle the diagnosis.

A clinician examines the bursa and surrounding joint, checks for skin damage and may remove bursal fluid with a needle. Laboratory testing can look for infection and crystals. Blood tests or imaging may be added when deeper infection or spread is a concern.

Arrange same-day medical assessment for a hot, red, increasingly painful bursal swelling, particularly after broken skin or if you feel feverish. Cover any open area with a clean dressing and avoid pressure on it. Do not squeeze, lance or drain the swelling.

Treatment is selected after clinical assessment and may include antibiotics and drainage. Take prescribed antibiotics exactly as directed and return for review if redness spreads, pain increases or general health worsens. A cortisone injection is not used in a bursa when infection is suspected.

Seek urgent care now for rapidly spreading redness, severe or escalating pain, fever with shaking chills, confusion, faintness, fast breathing, or marked weakness. Also obtain urgent help if swelling is accompanied by an inability to move the nearby joint, because infection inside the joint needs rapid evaluation.

Contact the treating service promptly if symptoms fail to improve after antibiotics begin, medication cannot be kept down, or drainage develops. People taking immune-suppressing medicine should mention it during triage.

Ask whether fluid should be sampled, how results could change treatment, how to protect the area, and which changes mean you should return immediately. Confirm whether follow-up is needed to check that the infection and swelling have resolved.