Fusobacterium necrophorum plays a causal role in a rare and life-threatening 
condition, Lemierre's syndrome. It is characterized by infection involving the 
posterior compartment of the lateral pharyngeal space complicated by septic 
suppurative thrombophlebitis of the internal jugular vein with F. necrophorum 
bacteremia and metastatic abscesses, primarily to the lung and pulmonary septic 
emboli. Herein, we present a very rare case of oropharyngeal infection 
complicated by Lemierre's syndrome with characteristic septic emboli to the 
lungs presenting as sore throat in a previously healthy patient. A 23-year-old 
woman presented with sore throat and was found to be in sepsis and acute kidney 
injury. She was found to have septic emboli in lung and Streptococcus anginosus 
and F. necrophorum in blood. She was diagnosed with Lemierre's syndrome and 
successfully treated with antibiotics. Lemierre's syndrome should be included in 
the differential diagnosis in young patients who deteriorate in the setting of a 
sore throat. If the suspicion is high, throat swabs from young patients with 
nonstreptococcal group A tonsillitis should be cultured anaerobically on 
selective medium to detect the presence of F. necrophorum. While clinicians of 
the infectious disease team may be familiar with this condition other 
departments including internal medicine and critical care team may less so. 
Unless clinicians are aware of this syndrome, diagnosis and treatment can be 
delayed leading to higher morbidity and mortality.