title: Isotretinoin and Staphylococcus aureus infection. A possible association.
abstract: The use of isotretinoin (13-cis-retinoic acid) in the treatment of numerous dermatologic disorders, as well as the side effects encountered with use of the drug, have increased remarkably since its release. We encountered a case of Staphylococcus aureus endocarditis in a patient with chronic stable aortic insufficiency undergoing therapy with isotretinoin for extensive actinic keratoses. Although significant dysfunction of the immune system has not been demonstrated with isotretinoin, nasal colonization with S aureus has been shown to occur. Changes in skin fragility caused by the drug may provide a portal of entry for the organism. Physicians should be alert for this potential complication in patients with an underlying cardiac valvular lesion; antibiotic prophylaxis may be indicated in this group during isotretinoin therapy.
authors.forename: M L
authors.initials: ML
authors.lastname: Graham
authors.forename: R
authors.initials: R
authors.lastname: Corey
authors.forename: R
authors.initials: R
authors.lastname: Califf
authors.forename: H
authors.initials: H
authors.lastname: Phillips
mesh_terms: D001022:Aortic Valve Insufficiency / Q000150:complications; D004697:Endocarditis, Bacterial / Q000209:etiology*; D006801:Humans; D007536:Isomerism; D015474:Isotretinoin; D007642:Keratosis / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012306:Risk; D012867:Skin / Q000187:drug effects* / Q000382:microbiology; D013203:Staphylococcal Infections / Q000209:etiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification; D014212:Tretinoin / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D014212:Tretinoin; D015474:Isotretinoin