We encountered a patient with a history of intravenous drug use presenting with fever, malaise and nausea who was found to have cavitary lung lesions. Unexpectedly, gram positive rods grew out on day five on multiple blood cultures, which were later identified as Mycobacterium fortuitum. The patient underwent transesophageal echocardiogram, which showed aortic and tricuspid valve vegetations. Liver biopsy demonstrated granulomatous hepatitis. Interestingly, serum alkaline phosphatase level fell with antibiotic treatment. Mycobacterium fortuitum is ubiquitous worldwide, being found in tap water, and soil. M. fortuitum is usually considered as a contaminant. Disseminated infection caused by this bacterium in an immunocompetent host is extremely rare. Most of the disseminated infections have been reported in immune-deficient patients. In immunocompetent people, M. fortuitum causes human infection primarily by direct inoculation, including localized post-traumatic and surgical wound infections, and catheter-related sepsis. Our patient, an HIV-negative intravenous drug user, had Mycobacterium fortuitum sepsis associated with infective endocarditis, septic pulmonary emboli, and granulomatous hepatitis. Interestingly, the patient admitted using tap water occasionally for mixing heroin when her sterile water ran out, which we thought was the likely source of M. fortuitum.

Study Objectives: To evaluate the efficacy of post-operative antibiotic prophylaxis in mandibular fractures. Study Design and Settings: It was a randomized controlled trial carried at of Department of Oral & Maxillofacial Surgery Akhtar Saeed Medical & Dental College Lahore from January 2021 to June 2021. Patients and Methods: After accepting to be enrolled in the study 50 patients with mandible fractures were randomly assigned into two groups Group A and Group B respectively. From admission until 24 hours post-operatively, all patients were given prophylactic antibiotic. The patients were than evaluated for evidence of infection at 6 weeks post-operatively.. Results of the Study: The age incidence varied from 18-60 years. The maximum number of patients belongs to age group 20-30 years. In a total of 50 patients, 45 male and 5 female patients were enrolled for the study. 4 of 25 patients in group A (16%) and 3 of 25 patients in group B (12%) reported with infection during follow-up. No statistically significant difference in the incidence of infection was noted between the groups Conclusion: In this study it was concluded that 1 day post-operative antibiotic is adequate to prevent post-operative infection in uncomplicated mandible fractures. The extended use of post-operative prophylactic antibiotic does not affect the incidence of infection in uncomplicated mandible fracture. Keywords: Mandibular Fractures, Post-Operative Antibiotic, Efficacy