{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:33:21Z","timestamp":1786649601570,"version":"build-2736575974"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"Abstract<\/jats:title>\n \n Rationale:<\/jats:title>\n \n Actinomycotic osteomyelitis of the maxilla is a rare, chronic infection caused by\n Actinomyces<\/jats:italic>\n species. Owing to the rich vascularity of the maxilla, involvement is uncommon, often leading to delayed diagnosis and increased morbidity if untreated.\n <\/jats:p>\n <\/jats:sec>\n \n Patient Concerns:<\/jats:title>\n A patient presented with a 6-month history of dull, persistent maxillary pain following the extraction of right upper first premolar.<\/jats:p>\n <\/jats:sec>\n \n Diagnosis:<\/jats:title>\n Clinical examination revealed an oroantral fistula with an exposed, mobile sequestrum. Sequestrectomy with histopathological evaluation confirmed actinomycotic osteomyelitis.<\/jats:p>\n <\/jats:sec>\n \n Treatment:<\/jats:title>\n \n Sequestrectomy with thorough debridement and intranasal antrostomy was performed for adequate sinus drainage. Prolonged high-dose intravenous antibiotics were administered, followed by oral therapy targeting\n Actinomyces<\/jats:italic>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Outcomes:<\/jats:title>\n At 1-year follow-up, the patient was asymptomatic with no evidence of recurrence.<\/jats:p>\n <\/jats:sec>\n \n Take-away Lessons:<\/jats:title>\n It is rare and often difficult to diagnose due to non-specific symptoms and negative cultures. Early suspicion, histopathological confirmation and individualised regimens considering patient compliance and access to care, plus long-term follow-up, ensure favourable outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ams.ams_146_25","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T06:01:40Z","timestamp":1777356100000},"page":"120-123","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["A Case of Actinomycotic Osteomyelitis in Maxilla Presenting as Oroantral Fistula \u2013 A Rare Case Report"],"prefix":"10.4103","volume":"16","author":[{"given":"H. T Arvind","family":"Rao","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Yenepoya Dental College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vini Dharmendra","family":"Machchhar","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Yenepoya Dental College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashwin","family":"Harekal","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Yenepoya Dental College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jagadish","family":"Chandra","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Yenepoya Dental College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V. K.","family":"Vineeth","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Yenepoya Medical College, Mangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"R1-20260703","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/S1079-2104(98)90280-3","article-title":"Cervicofacial actinomycosis","volume":"85","author":"Miller","year":"1998","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"key":"R2-20260703","doi-asserted-by":"crossref","first-page":"863","DOI":"10.18203\/issn.2454-5929.ijohns20181889","article-title":"A rare case of sinonasal actinomycosis-enigmatic presentation","volume":"4","author":"Gupta","year":"2018","journal-title":"Int J Otorhinolaryngol Head Neck Surg"},{"key":"R3-20260703","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1038\/sj.bdj.2009.115","article-title":"Actinomycosis of the maxilla \u2013 A case report of a rare oral infection presenting in general dental practice","volume":"206","author":"Crossman","year":"2009","journal-title":"Br Dent J"},{"key":"R4-20260703","doi-asserted-by":"crossref","first-page":"124","DOI":"10.3390\/antibiotics9030124","article-title":"Actinomycosis of the tongue: A case report and review of literature","volume":"9","author":"D'Amore","year":"2020","journal-title":"Antibiotics (Basel)"},{"key":"R5-20260703","doi-asserted-by":"crossref","first-page":"113","DOI":"10.4103\/ijohs.ijohs_19_20","article-title":"An unusual case of intraoral actinomycosis: Case report and literature review","volume":"10","author":"Sharma","year":"2020","journal-title":"Int J Oral Health Sci"},{"key":"R6-20260703","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.3390\/antibiotics11081067","article-title":"Actinomyces sp. Presence in the bone specimens of patients with osteonecrosis of the jaw: The histopathological analysis and clinical implication","volume":"11","author":"Ibrahim","year":"2022","journal-title":"Antibiotics (Basel)"},{"key":"R7-20260703","doi-asserted-by":"crossref","first-page":"140","DOI":"10.18203\/2349-3291.ijcp20214955","article-title":"Actinomycosis in head and neck region of pediatric patients: A review","volume":"9","author":"Swain","year":"2022","journal-title":"Int J Contemp Pediatr"},{"key":"R8-20260703","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1007\/s12663-019-01201-4","article-title":"Maxillofacial osteomyelitis in immunocompromised patients: A demographic retrospective study","volume":"19","author":"Sood","year":"2020","journal-title":"J Maxillofac Oral Surg"},{"key":"R9-20260703","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.humpath.2005.09.018","article-title":"Actinomyces in infected osteoradionecrosis \u2013 Underestimated?","volume":"37","author":"Hansen","year":"2006","journal-title":"Hum Pathol"},{"key":"R10-20260703","doi-asserted-by":"crossref","first-page":"487","DOI":"10.4103\/jiaomr.jiaomr_190_21","article-title":"Actinomycotic osteomyelitis of maxilla in a diabetic patient-\"a rare case report and review of literature\"","volume":"33","author":"Bhagawati","year":"2021","journal-title":"J Indian Acad Oral Med Radiol"}],"container-title":["Annals of Maxillofacial Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ams.ams_146_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:55:50Z","timestamp":1786647350000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ams.ams_146_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ams.ams_146_25","relation":{},"ISSN":["2231-0746","2249-3816"],"issn-type":[{"value":"2231-0746","type":"print"},{"value":"2249-3816","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-07-25","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-30","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}