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   Table of Contents     
LETTER TO EDITOR  
Year : 2015  |  Volume : 7  |  Issue : 2  |  Page : 93-94
Primary septic greater trochanteric bursitis


1 Department of Infection Control, Coordinated Health, Allentown, Pennsylvania, USA
2 Department of Clinical Education and Research, Coordinated Health, Allentown, Pennsylvania, USA
3 Department of Orthopedics, Coordinated Health, Allentown, Pennsylvania, USA

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Date of Web Publication19-May-2015
 

How to cite this article:
Novatnack ES, Protzman NM, Weiss CB. Primary septic greater trochanteric bursitis. J Global Infect Dis 2015;7:93-4

How to cite this URL:
Novatnack ES, Protzman NM, Weiss CB. Primary septic greater trochanteric bursitis. J Global Infect Dis [serial online] 2015 [cited 2019 Nov 15];7:93-4. Available from: http://www.jgid.org/text.asp?2015/7/2/93/154448


Sir,

Greater trochanteric (GT) bursitis arising from noninfectious etiologies is well-documented; [1] however, reports describing septic GT bursitis are scarce. [2],[3],[4],[5] An 81-year-old man presented with acute lateral hip pain following the initiation of twisting exercises. There were no visible skin abnormalities and no history of invasive procedures. Upon palpation, the hip demonstrated trochanteric bursa swelling and tenderness. Clinically presenting as acute aseptic GT bursitis, triamcinolone acetonide was injected into the left superficial GT bursa. Afterward, an abnormally large amount of cloudy fluid leaked from the injection site. The bursa was aspirated, and 2 ml of yellow, semi-purulent fluid was obtained and sent for aerobic and anaerobic culture. The patient was placed on prophylactic antibiotics (sulfamethoxazole-trimethoprim DS). Lab work demonstrated a sedimentation rate of 54 mm/h and a C-reactive protein level of 161.0 mg/l. The culture revealed methicillin-sensitive Staphylococcus aureus, supporting the diagnosis of septic GT bursitis. With oral antibiotics alone, the condition resolved in 2.5 weeks. From this information, the authors conclude that the twisting exercises irritated and inflamed the GT bursa, and the collected fluid became seeded with bacteria. Therefore, deep bursal infections should be considered with acute lateral hip pain, especially following activities that could cause repetitive micro-trauma.

 
   References Top

1.
Aaron DL, Patel A, Kayiaros S, Calfee R. Four common types of bursitis: Diagnosis and management. J Am Acad Orthop Surg 2011;19:359-67.  Back to cited text no. 1
    
2.
Crespo M, Pigrau C, Flores X, Almirante B, Falco V, Vidal R, et al. Tuberculosis trochanteric bursitis: Report of 5 cases and literature review. Scand J Infect Dis 2004;36:552-8.  Back to cited text no. 2
    
3.
García-Porrúa C, González-Gay MA, Ibañez D, García-País MJ. The clinical spectrum of severe septic bursitis in northwestern Spain: A 10 year study. J Rheumatol 1999;26:663-7.  Back to cited text no. 3
    
4.
Lynch AF. Tuberculosis of the greater trochanter. A report of eight cases. J Bone Joint Surg Br 1982;64:185-8.  Back to cited text no. 4
    
5.
Makki D, Watson AJ. Septic trochanteric bursitis in an adolescent. Am J Orthop (Belle Mead NJ) 2010;39:E1-3.  Back to cited text no. 5
    

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Correspondence Address:
Nicole M Protzman
Department of Clinical Education and Research, Coordinated Health, Allentown, Pennsylvania
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-777X.154448

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2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
Online since 10th December, 2008