Inadvisable Treatment of Recalcitrant Septic Olecranon Bursitis: An Unusual Case of Extremely Prolonged Treatment With Oral Antibiotics After Bursectomy

Todd C. Pitts, Casey J. Kiser, John G. Skedros

Abstract


    The intention of this report is to alert physicians about how prolonged the course of treatment for recalcitrant septic olecranon bursitis (OB) might be when only oral antibiotics are used. Some patients may need extra convincing that this course of treatment could be so long that it would not be recommended (i.e., a relatively shorter course of i.v. antibiotics is preferred). We treated a 56-year-old healthy male who developed methicillin-sensitive Staphylococcus aureus (MSSA) OB after a scorpion sting. The infection was not eradicated with bursectomy and a conventional course of antibiotics. The unusual persistence of the infection was initially attributed to venom, but olecranon osteomyelitis was eventually suspected. The patient refused a typical and predictably effective course of i.v. antibiotics because this would have constrained his business travel schedule. Consequently, full resolution required 240 days; treatment being mainly with two concurrent antibiotics (trimethoprim/sulfamethoxazole and rifampin).




 doi:10.4021/jmc463w

Keywords


Olecranon bursitis; Olecranon osteomyelitis; Elbow infection; Oral antibiotics; Patient compliance

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