Painless Buccal Abscess With Intraoral Fistula in an Older Woman

A woman in her 70s was brought to the emergency department with a right distal femoral fracture after being found immobile at home for an estimated 6 days. Her medical history included common bile duct stones without immunosuppressive conditions. On admission, she was alert and oriented, tachycardic with a normal respiratory rate, low-grade fever of 37.4°C, and no hypoxemia. Right cheek swelling with erythema was incidentally noted; the patient denied any associated pain (Fig 1A). Laboratory studies revealed leukocytosis, elevated C-reactive protein levels, and acute kidney injury.