A 63-year-old woman with atrial fibrillation, who was receiving warfarin and had a history of atrial septal defect (ASD) and ventricular septal defect (VSD) repair in her 20s, presented with stupor and new facial droop. A computed tomographic examination of the brain showed a right frontal lobe abscess with vasogenic edema (Figure 1). She underwent burrhole aspiration of the abscess, which grew mixed oral flora. Treatment involved a prolonged course of intravenous antibiotics, steroids, and medications for seizure prophylaxis.