Infrapatellar bursitis with Mycobacterium malmoense related to immune reconstitution inflammatory syndrome in an HIV-positive patient

Septic Infrapatellar Bursitis in an Immunocompromised Female

Bursitis is a relatively common occurrence that may be caused by traumatic, inflammatory, or infectious processes. Septic bursitis most commonly affects the olecranon and prepatellar bursae. Staphylococcus aureus accounts for 80% of all septic bursitis, and most cases affect men and are associated with preceding trauma. We present a case of an 86-year-old female with an atypical septic bursitis involving the infrapatellar bursa. Not only are there very few reported cases of septic infrapatellar bursitis, but also this patient's case is particularly unusual in that she is a female with no preceding trauma who had Pseudomonas aeruginosa on aspirate. The case also highlights the diagnostic workup of septic bursitis through imaging modalities and aspiration. This patient had full resolution of her septic bursitis with appropriate IV antibiotics.

The morel-lavallée lesion as a rare differential diagnosis for recalcitrant bursitis of the knee: case report and literature review

A 72 year-old-male was referred to our institution with recalcitrant prepatellar bursitis. The injury was sustained after striking his right knee against a post whilst horse riding 9 months ago. Previous treatments included repeated aspiration and excision of the bursa with elastic compression bandaging. A diagnosis of a Morel-Lavallée internal degloving injury was made, and the lesion was satisfactorily managed by an internal quilting procedure to eliminate the potential dead space. A review of the literature reveals 29 published reports of Morel-Lavallée lesions with sufficient information for inclusion. These came from 14 separate countries with a total of 204 lesions in 195 patients. The most common anatomical location was the greater trochanter/hip (36%), followed by the thigh (24%) and the pelvis (19%). Most were managed surgically with evacuation of the haematoma and necrotic tissue followed by debridement, which was often repeated (36%). Conservative treatment with percutaneous aspiration and compression bandaging was the next most common treatment (23%). The knee was the fourth most common region affected (16%), and only 3 other lesions in the literature have been managed with a quilting procedure.