Postop the patient cannot tolerate oral Amoxicillin because of stomach upset.  The dose is reduced.  Two weeks postop, the perio dressing is stable, but discolors (Fig.13). 

Retrospectively, the discoloration is due to mild residual infection from the surgical site.  The apical fistula should have been sealed intraop.  An alternative antibiotic should have been prescribed when the patient had an adverse reaction to Amoxicillin.  The apical fistula should have been doubly checked in the 2-week follow up and treated accordingly.

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Xin Wei, DDS, PhD, MS 1st edition 09/20/2014, last revision 01/19/2018