Toronto's right-hander was shut down early in camp because of inflammation in his shoulder. Litsch visited renowned surgeon Dr. James Andrews for a full diagnosis on Monday that confirmed the inflammation and didn't find any structural damage.
That was supposed to be good news, and Litsch received a platelet-rich plasmas (PRP) injection to help with the healing process. Unfortunately for Litsch and the Blue Jays, that injection caused a serious infection, and Litsch will not be allowed to throw for at least the next six weeks.
"He had a reaction to the injection that actually caused an infection, and as that began to grow, there was an additional procedure needed to clean out the infection," Blue Jays manager John Farrell said of the eventual arthoscopic surgery.
"It was an emergency procedure because the infection was growing, so that had to be flushed out."
The use of platelet-rich plasma injections have become more common in recent years. Athletes such as Jose Reyes and Ian Kinsler have undergone the procedure, while former Blue Jays left-hander Jesse Carlson also received the treatment to repair an injury to his left biceps tendon in 2011.
The procedure involves injecting portions of a patient's blood into the affected area with the hope that it accelerates the healing process with the muscle, bone or other tissue. The blood that is used during the treatment is removed from the body and then rotated at high speed to separate red blood cells from the platelets.
The platelets release proteins and other particles that are used in the healing process, and a small amount is then inserted back into the body through the infected area. The procedure has been very effective for athletes across all professional sports and by all accounts is considered relatively safe but just like any other medical treatment there is always the chance that something could go wrong.
"It's a very minute risk with any injection that an infection could follow, and yet in this case, unfortunately for [Litsch], it has," Farrell said.
"He required an arthroscopic procedure to clean [the infection] out. He's having to deal with antibiotics daily now for the next four weeks. It's an unfortunate setback for him."
Litsch has been completely shut down for the next two weeks, and during that time, he is unable to go through any kind of conditioning program. After that, he can slowly begin to work himself back into shape, but he will be unable to go through full baseball activities for at least a month and a half.
That means Litsch won't be able to begin throwing until the middle of April and likely won't be able to get onto a mound until much later that. He will essentially have to start from scratch, and in all probability, he will take part in extended spring training upon his return.
It's the latest in a series of injury woes for the native of Tampa in recent years. In 2009, he underwent Tommy John surgery, and last season, he spent 54 days on the disabled list with an impingement in his right shoulder.
Litsch had been in competition for one of the final two spots in Toronto's bullpen with Carlos Villanueva, Luis Perez, Rick VandenHurk and Evan Crawford. The shoulder injury eliminates any chance of Litsch heading north with the club, and after extended spring training, he'll likely have to go through a lengthy rehab assignment before the club decides whether he'll join the Blue Jays or Triple-A Las Vegas.
Despite the setback, Farrell said that Litsch has remained positive after undergoing the procedure on Wednesday and remaining in the hospital for two and a half days.
"We've had a number of conversations, with yesterday being the most recent when he was released from the hospital," Farrell said of Litsch, who will take antibiotics four times a day. "He's at home; there was really no decision in this.
"With the onset of the injection, this had to get taken care of. So while he knows this is the hand that has been dealt him, he remains upbeat. I know he feels better being at home than being in a room, so he is under the watchful eye right of the medical staff and receiving his antibiotics daily."
The 26-year-old Litsch began last year in the starting rotation, but he transitioned to the bullpen following his shoulder ailment. He went 6-3 with a 4.44 ERA in 75 innings at the big league level and possesses a 4.16 ERA in parts of five seasons in the Majors.