Subacromial/subdeltoid septic bursitis associated with isotretinoin therapy and corticosteroid injection.

Subacromial septic bursitis after corticosteroid injection is exceedingly rare. This report describes a case of Staphylococcus aureus subacromial septic bursitis after corticosteroid injection in a patient undergoing isotretinoin (Accutane) therapy. This case is only the third reported in the literature linking a corticosteroid injection with septic subacromial bursitis and the first to describe an association with isotretinoin therapy. Isotretinoin is an established treatment of severe nodulocystic acne and a variety of dermatologic conditions. Infectious complications from isotretinoin are rare. However, increased S aureus colonization of the nasal mucosa and skin is well established, and cases of S aureus infection associated with isotretinoin therapy are reported. Isotretinoin should be recognized as a risk factor for developing infections such as septic bursitis after percutaneous injection. Physicians performing these injections should be aware of this uncommon complication.