Septic bursitis in childhood.

Ten cases of septic bursitis in children during a 25 year period were reviewed. Infection occurred in five girls and five boys with a mean age of 9 1/6 years. None had prior bursal disease. Direct trauma or local infection preceded the bursitis in seven children. The involved bursae were prepatellar (eight), olecranon (one), and subacromial (one). Presenting signs included fever with localized swelling, tenderness, and erythema; superficial fluctuance and painless joint motion were helpful diagnostic findings. Bursal fluid cultures yielded Staphylococcus aureus (nine) and Streptococcus pyogenes (one). Surgical therapy included needle aspiration (three), incision and drainage (three), and both procedures (four). Antimicrobial therapy was given to nine children; four received only oral antimicrobials. Nine children including all who received oral antimicrobials recovered rapidly without apparent sequelae. One child's course was complicate by patellar osteomyelitis and septic arthritis. Septic bursitis is an uncommon infection in children and should be differentiated from cellulitis and septic arthritis. Rapid recovery is usually seen with appropriate therapy.