A 22-year-old, white woman presented with fever, sore throat, and left jaw pain for 4 days. Dental caries of her left lower third molar were diagnosed 3 days prior to presentation; she was started on oral penicillin and metronidazole, and was scheduled for tooth extraction. She continued to have fevers, decreased oral intake, and swelling in the left jaw developed. The patient was otherwise healthy, with no previous medical or surgical problems. She denied tobacco, ethanol, or drug abuse. Occupational and family histories were unremarkable.