When Medications Harm Muscles: A Case of a Teenager With Acute Rhabdomyolysis

Rhabdomyolysis is a rare but serious adverse effect of isotretinoin therapy, especially when combined with strenuous physical activity. We present a case of drug-induced rhabdomyolysis with secondary intramuscular abscesses in an adolescent. A 16-year-old male on standard-dose isotretinoin presented with a four-day history of right gluteal and thigh pain and fever, without a history of trauma, but with recent intense physical activity. Laboratory tests showed elevated inflammatory markers, creatine kinase, and myoglobinuria. MRI demonstrated extensive myositis with multiple intramuscular and intermuscular abscesses requiring hydration, antibiotics, drug discontinuation, and surgical drainage, leading to full recovery. This case emphasizes the need for early recognition of isotretinoin-associated rhabdomyolysis, particularly in physically active patients. Prompt imaging, cessation of the offending agent, and timely intervention can prevent renal injury and improve outcomes.