A 60-year-old female presented to the OPD with complaints of left jaw pain along with fever. On examination, Poor dentition Area of purulent drainage in the mouth Right sided facial swelling Diffuse mandibular tenderness Medication history includes alendronate and lisinopril. Microscopic examination of the purulent secretions is done. What is the most appropriate drug for the above condition: -
This is a case of osteonecrosis of jaw which is a risk factor for Actinomyces infection. 1st image shows lesions from bisphosphonate-related osteonecrosis of the jaw at extraction sites of upper central incisors. Microscopy shows chronic inflammatory changes with Sulphur granules. Actinomyces It has propensity to infect the jaw. Risk factors are: - Abnormal bone due to radiation Osteonecrosis of jaw Gram staining shows intense positive staining at the centre with branching rods at the periphery. It is very sensitive to penicillin therapy.
Penicillin
Azithromycin
Griseofulvin
Metronidazole
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