Risk factors, especially in an immunocompromised host (see previous section):
(1) abrasion to the skin over the elbow
(2) penetrating trauma or surgery to the elbow
(3) environmental exposure with a pre-existing wound adjacent to the elbow
(4) environmental exposure with pre-existing chronic bursitis
Clinical features:
(1) gradual onset over weeks
(2) mild induration of the bursa
(3) tenderness over the elbow
(4) erythema over the elbow
(5) production of serosanguinous fluid, with effusion or discharge
Diagnosis is usually not suspected until organisms are:
(1) identified in the histologic sections prepared from the resected tissue (need to be distinguished from deep fungal pathogens such as Coccidioides)
(2) grown in culture
