Challenges in Managing External Dental Fistula in an Immunocompromised Elderly Patient: A Case Report

This case report discusses a 69-year-old immunocompromised woman who presented with dyspnea and lower back pain, later diagnosed with an external dental fistula following the observation of a mass and pus discharge on her right cheek. The patient's medical history included idiopathic thrombocytopenic purpura (ITP) and long-term use of immunosuppressive medications, complicating her condition. The fistula was linked to chronic inflammation that had progressed to maxillary bone destruction, requiring both antibiotic therapy and oral surgical intervention. Despite the initial challenge of diagnosing this rare and atypical presentation in elderly, immunosuppressed patients, comprehensive treatment improved her inflammatory markers and overall condition. This case highlights the importance of early detection and multidisciplinary management in preventing severe complications in patients with complex medical histories. It also emphasizes the need for heightened awareness of dental infections in patients with systemic conditions, mainly when presenting atypical symptoms.