What causes septic (infectious) bursitis?

Updated: Dec 11, 2020
  • Author: Kristine M Lohr, MD, MS; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Septic (infectious) bursitis is most common in superficial bursae. In the majority (50-70%) of cases, it results from direct introduction of microorganisms through traumatic injury or through contiguous spread from cellulitis (50-70% of cases). Less commonly, infection of deep bursae is due to contiguous septic arthritis or bacteremia (10% of cases).

The most common causative organism is Staphylococcus aureus (80% of cases), followed by streptococci. However, many other organisms have been implicated in septic bursitis, including mycobacteria (both tuberculous and nontuberculous strains), fungi (Candida), and algae (Prototheca wickerhamii). [22]  A case of olecranon bursitis caused by Brucella melitensis has been reported. [23]

Factors predisposing to infection include diabetes mellitus, steroid therapy, uremia, alcoholism, skin disease, and trauma. A history of noninfectious inflammation of the bursa also increases the risk of septic bursitis.

A case of methicillin-resistant Staphylococcus aureus (MRSA)-caused septic bursitis was reported in an injection drug user following an attempt to inject drugs into the soft tissue of the knee. [24]


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