Olecranon septic bursitis managed in an ambulatory setting

Background: The epidemiology, outcome and management of olecranon septic bu rsitis (OSB) have not been described in a large cohort of ambulatory patien ts. Methods: A retrospective study of all 118 cases of OSB presenting over 21 m onths to all regional Home Parenteral Therapy Program clinics in Calgary (r eferral base approximately 1 million). Results: The minimum population annual incidence was 10/100 000. The mean ( and standard deviation) age was 44 (13) years, and males predominated (88%) . One-third of patients had at least one comorbid illness, with preceding i njury in 53% of cases. The most common symptoms were pain (87%), redness (7 7%) and fever or chills (45%). Common signs included erythema (92%), swelli ng (85%), edema (75%), tenderness (59%), fluctuance (50%), heat (36%) and r educed range of motion (27%). Fever (body temperature of greater than or eq ual to 37.8 degreesC) occurred in 20%. Staphylococcus aureus was identified in 88% of culture-proven cases of OBS. The most common antibiotic regimen was sequential intravenous administration of cefazolin (for a median of 4 d ) followed by clindamycin orally (for a median of 8 d). Sixty (51%) patient s required a drainage procedure and only I patient required admission to ho spital. Conclusion: OSB is more common than reported and can be treated suc cessfully in ambulatory settings with sequential intravenous therapy follow ed by oral therapy and drainage in selected cases.