Can septic bursitis kill you

Can septic bursitis kill you?




The correct and short answer to this question is YES, septic bursitis can cause septicemia and lead to fetal outcome. But fortunately, this is not the common case in the majority of patients with septic bursitis and usually this infection heals thoroughly without any problem or complication by itself. If you or anyone around you have septic bursitis, we highly recommend you to read the following article and get yourself familiar with this disease to get answers to the following questions:

  • What is septic bursitis or infectious bursitis?
  • Is purulent bursitis a dangerous and serious condition?
  • Is septic bursitis life threatening?
  • Can septic bursitis cause death?

In the following, we will introduce you to the concept of bursitis, then we will explain infectious or septic bursitis in more detail.


What does bursitis mean?

Statistics and epidemiology

What are the causes of bursitis?

Which body bursa are vulnerable to septic bursitis?

Signs and symptoms of infectious or septic bursitis

Diagnosis of septic bursitis

Treatment of septic bursitis

Can septic bursitis be fatal and life threatening?

Who are considered At-risk group for fetal septic bursitis?

Complications of spreading the infection into the blood



What does bursitis mean?

Between our tendons and bones, and especially around the joints, is a fluid-filled sac called the bursa that reduces the friction between the moving parts within the joints. The bursa also acts as a shock absorber.

In the human body, there are a total of about one hundred and sixty bursae located around the shoulders, pelvis, knees, elbows, and the Achilles tendon in the foot. The walls of these fluid-filled sacs are covered by cells called synovial cells, whose functions are to produce and secrete a fluid full of collagen and protein into the bursa.

The inflammation of bursa is called bursitis. If the bursa’s wall becomes inflamed for example following exercise and improper physical activity, the patient will feel pain during joint movements. But this inflammation is aseptic meaning that no bacteria will be found when testing the bursa’s fluid. Non-infectious or aseptic bursitis will be relieved automatically by joint rest and cessation of heavy joint movements.

But sometimes bursae that are close to the surface of our skin will become infectious. This is more common in patients:

  • with diabetics
  • with weakened immune systems
  • who have been taking corticosteroids for a long time
  • with kidney disease
  • or suffering from liver disease


Statistics and epidemiology:

One out of five bursitis will become infectious and cause septic bursitis. Septic bursitis is more common in the superficial bursae of the body and often occurs following trauma and injury around the joint area. In these cases, the microbial agents and bacteria that cause the bursa infection enter through the damaged skin duct and cause infection in the superficial bursa. Cellulite or superficial infections of the skin damaged during trauma is responsible for fifty to seventy percent of all infectious bursitis.

Males are more likely to have septic bursitis than females. Eighty-five percent of all patients with septic bursitis are males. But let’s see why the bursa becomes inflamed.


What are the causes of bursitis?

There are many different types of bursitis classification in medical literatures. The simplest classification of bursitis that is based on the properties of the etiologic factors is listed below:

  • Bursitis caused by injury:

Inflammation of the bursa may happen if the bursa is injured directly or repeatedly by internal or external forces.

Based on severity and duration of the force, the bursitis in this group may further be classified into two groups. One group is bursitis that are caused by small repetitive forces like wearing tight pants that may cause trochanteric bursitis for example.

In the other group, bursitis will occur by a single but severe injury like what happen in car accidents or sport injuries. In this group, almost always bursitis is caused by the collection of blood inside bursa.

In general, traumas can cause two types of bursitis:

  1. Acute bursitis:

It is caused by a severe and direct trauma to the bursa. For example, a direct trauma to the knee is accompanied by painful inflammation and swelling of the bursa around the knee.

  1. Chronic bursitis:

Occurred by repeated but minor traumas to the bursa. For example, shoulder bursitis may occur following repeated throwing of the ball by baseball or basketball players. Or the bursitis around the knee due to the repeated or prolonged kneeling.

Almost every rheumatic disease can cause bursitis. These types of bursitis later may become infectious and cause septic bursitis. For example, patients suffering from gout may develop inflammatory bursitis following the accumulation of urea crystals in the bursa.

  • Infection

The spread of infectious bacteria to bursa close to the skin can cause infectious or septic bursitis as well. Bacteria may enter the bursa directly from the wound duct created following trauma to the skin adjacent to the bursa.

Bacteria that cause cellulite and skin infections may also reach the nearby bursa indirectly. People with immunodeficiency or people with weakened immune systems, such as diabetics and chronic users of corticosteroids and other immunosuppressive drugs, are more likely to develop infectious septicemia.

Which infectious agents cause infectious bursitis or septic?

  • Staphylococcus aureus:

Staphylococcus aureus is the most common cause of septic bursitis. Near eighty percent of all septic bursitis is believed to be caused by Staphylococcus aureus.

  • Streptococcus:

The second bacterium that can cause infectious bursitis is Streptococcus pyogenes.




Which body bursae are more vulnerable to septic bursitis?

Bursae that are located just below the surface of the skin are more prone to septic bursitis. For example:

The buccal bursa, the bursa around patella of the knee, Olecranon bursa which is located just above the tip of the elbow bone all are prone to infections caused by abrasion, scratches, wounds, scrape, or even bug bites.


Signs and symptoms of infectious or septic bursitis

  • Swelling at the joint site
  • Localized pain at the joint site
  • Increased temperature of the joint surface
  • Regional redness
  • Fever
  • Generalized fatigue

Although death is not the outcome for septic bursitis in healthy normal patients, but it still may occur in the first twelve hours after the spread of infection if left untreated. It mostly happens due to the spread of infection in the blood in patients with compromised immune system.

Many people with rheumatoid arthritis, such as those who have a long lasting disease or a history of high dose corticosteroid consumption, are exposed to septic and sometimes life-threatening bursitis.


Diagnosis of septic bursitis

It is necessary to see a doctor in time to reduce the risks and get rid of the complications of infectious bursitis.

Note that septic bursitis is uncommon and is most likely to be mistaken with non-infectious inflammatory bursitis or so-called aseptic bursitis. When bursitis is suspected, specially when it is accompanied with swelling, heat, pain, and local redness, the fluid inside the bursa should be drained with a needle for testing.

Doctors call this process “aspiration”, and the discharged fluid must be analyzed by a laboratory to determine if the fluid is infectious. Accurate clinical examination along with the results of laboratory tests are very important in the correct and immediate diagnosis of septic bursitis.

Laboratory testing requires complete blood cell count along with analysis and bacteria culture testing of the aspirated fluid. An increase in the number of white blood cells in the bursa fluid indicates the presence of infection. In addition, in the case of an infection, the amount of glucose in the joint fluid will be greatly reduced. Sometimes, the bursa fluid will be evaluated from other aspects such as the presence of sedimentary crystals as well.

If the items and tests mentioned above are not helpful, your doctor may use ultrasound and in some cases MRI to better diagnose the problem. The reason is that many cases of infectious bursitis are often mistaken for arthritis. Remember that infectious bursitis is considered as a medical emergency and should be treated ASAP.


Treatment of septic bursitis

Treatment for infectious bursitis should be started immediately. In some cases, your doctor may prescribe an oral antibiotic that is appropriate for your condition. He or she may also recommend that the bursa be examined every three to five days by removing the infectious fluid for testing.

In cases where it is not possible to be treated with oral antibiotics or if the appropriate treatment response is not received orally, especially in people with weakened immune systems, the patient should be hospitalized and receive injectable antibiotics.

When these treatments are not effective, the next option may be the surgical drainage with a needle which requires a surgery. 

In some septic bursitis that are located deep inside body, like those near hip and shoulder joints, you may be a candidate for surgery.


Can septic bursitis be fatal and life threatening?

Yes, in case of delayed or improper treatment, or misdiagnosis, especially in people with weakened immune systems, bacterial infections may enter the bloodstream and spread throughout the body worsening patient’s condition.

  • first stage:

Infection enters the bloodstream and triggers an inflammatory reaction throughout the body.

  • second stage:

In this stage, the infection in the blood affects the normal functions of vital organs such as heart, brain, lung, kidney, etc. in this stage, patient may experience dizziness, low blood pressure, loss of urine formation and chills.

  • third stage: Infectious shock or septic shock.

In this phase, following the secretion of specific chemical compounds in the process of infection and global inflammation, the vascular wall of vessels within the body begins to progressively dilate which will result in a decrease in blood pressure.

A drop in blood pressure prevents enough blood from reaching the brain, kidneys, and other vital organs. Eventually the lungs, brain, kidneys, and heart will fail resulting in an unfortunate death of the patient.


At-risk groups for fetal septic bursitis

The following people are more likely to develop an infection in the blood (known as sepsis) which can result in shock and death following an infectious bursitis:

  • People living with AIDS
  • Patients with rheumatoid arthritis, lupus and psoriasis
  • Patients with inflammatory bowel disease such as Crohn's disease and ulcerative colitis
  • People undergoing chemotherapy
  • People undergoing special immunotherapy
  • Diabetic people with uncontrolled sugar and insulin consumption
  • People with chronic diseases
  • People with malnutrition


Complications of spreading the infection in the blood

The spread of infection in the blood or sepsis is associated with very serious and sometimes fatal complications such as:

  • Kidney failure
  • Lung failure
  • Abnormal blood clot formation
  • Liver failure
  • Death

The only way to prevent these complications is to start treating any localized infection immediately.

Patient’s age, underlying diseases, general health of the affected person, location of infectious bursitis and time of initiation of treatment all will affect the survival rate of the patient.





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