case_images: PMC4586902_01
case_images: Clinical photograph showing oroantral fistula.
case_images: CRID2015-689240.001.jpg
case_images: PMC4586902_01_CRID2015-689240.001.jpg
case_images: fig1
case_images: There were necrosis and purulent discharge (Figure 1).
case_images: OPG showing destructive radiolucent lesion of right maxilla.
case_images: CRID2015-689240.002.jpg
case_images: PMC4586902_01_CRID2015-689240.002.jpg
case_images: fig2
case_images: The OPG showed a destructive lesion involving palate (Figure 2).
case_images: Photomicrograph of smear (10x) Gram's staining image of actinomycotic colony with peripheral neutrophilic aggregation.
case_images: CRID2015-689240.003.jpg
case_images: PMC4586902_01_CRID2015-689240.003.jpg
case_images: fig3
case_images: There were clumps of tangled masses of elongated bacilli with peripheral neutrophilic aggregation (Figure 3).
case_images: Photomicrograph of smear (oil immersion). Tangled mass of Periodic acid-Schiff (PAS) positive branching filaments.
case_images: CRID2015-689240.004.jpg
case_images: PMC4586902_01_CRID2015-689240.004.jpg
case_images: fig4
case_images: The filaments were non-acid fast and were PAS (Periodic acid-Schiff stain) positive (Figure 4).
case_images: Photomicrograph of biopsy (10x) H&E oral epithelium with large actinomycotic colonies ( ).
case_images: CRID2015-689240.005.jpg
case_images: PMC4586902_01_CRID2015-689240.005.jpg
case_images: fig5
case_images: The incisional biopsy from the soft tissue and adjacent exposed necrotic bone revealed a stratified squamous epithelium with large clumps of basophilic bacterial colonies resembling actinomycotic colonies (Figure 5).
case_images: Photomicrograph (10x) of H&E decalcified section. Necrotic thickened bony trabeculae with Actinomyces filaments on trabecular surface of bony spicules ( ), with extensive sclerosis of bone showing prominent resting and reversal lines (  ).
case_images: CRID2015-689240.006.jpg
case_images: PMC4586902_01_CRID2015-689240.006.jpg
case_images: fig6
case_images: The necrotic bone showed sclerosis with actinomycotic colonies within bony sequestra and on trabecular surface (Figure 6).
case_images: Photomicrograph (10x) H&E section. Extensive fibrosis with granulomas and degeneration of salivary gland acini.
case_images: CRID2015-689240.007.jpg
case_images: PMC4586902_01_CRID2015-689240.007.jpg
case_images: fig7
case_images: There was extensive fibrosis with resolving granulomas and no bacterial colonies were observed (Figures 7 and 8).
case_images: Photomicrograph (40x) of H&E. Resolving granulomas with giant cells.
case_images: CRID2015-689240.008.jpg
case_images: PMC4586902_01_CRID2015-689240.008.jpg
case_images: fig8
case_images: There was extensive fibrosis with resolving granulomas and no bacterial colonies were observed (Figures 7 and 8).
case_images: Postoperative photograph after 2 months of follow-up.
case_images: CRID2015-689240.009.jpg
case_images: PMC4586902_01_CRID2015-689240.009.jpg
case_images: fig9
case_images: The patient was recalled after one month and showed improvement with resolution of the lesion (Figure 9).