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In this case, the patient\u2019s HIV history and prior chemoradiation for anal squamous cell carcinoma contributed to this unique presentation. This case highlights the importance of heightened clinical suspicion, thorough imaging, and individualized operative management in high-risk patients presenting with a seemingly straight-forward pathology.<\/jats:p>","DOI":"10.1093\/jscr\/rjag840","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:30:30Z","timestamp":1788521430000},"source":"Crossref","is-referenced-by-count":0,"title":["Ischiorectal abscess with fistulization into the thigh, the \u2018perfect storm\u2019 patient"],"prefix":"10.1093","volume":"2026","author":[{"given":"Konstantina","family":"Kostara","sequence":"first","affiliation":[{"name":"Department of Surgery, Hudson Regional Health , Bayonne University Hospital, 29 E 29th St, Bayonne, NJ 07002,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Kozorosky","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hudson Regional Health , Bayonne University Hospital, 29 E 29th St, Bayonne, NJ 07002,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaban","family":"Gheith","sequence":"additional","affiliation":[{"name":"Department of Anatomical Sciences, St. George\u2019s University School of Medicine , University Centre Grenada, West Indies,","place":["Grenada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantine","family":"Baltzis","sequence":"additional","affiliation":[{"name":"Department of Emergency Medical Services, Jersey City Medical Center , 355 Grand St, Jersey City, NJ 07302,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasileios","family":"Kostaras","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hudson Regional Health , Secaucus University Hospital, 55 Meadowlands Pkwy, Secaucus, NJ 07094,","place":["United 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