Fusobacterium necrophorum is a rare infection most notable for causing 
Lemierre's syndrome. This consists of a primary oropharyngeal infection and 
septic thrombophlebitis, and one or more metastatic focus. Prior to the 
widespread use of antibiotics, Lemierre's syndrome commonly followed a rapidly 
progressing course, with a high mortality. We describe a case of a previously 
well 18-month-old boy who presented to the emergency department with a 3-week 
history of progressive, right-sided, painful neck swelling and systemic sepsis. 
He was initially treated conservatively with intravenous antibiotics, but 
ultimately required surgical drainage. Lemierre's syndrome is a rare condition 
with increasing incidence which can have significant adverse outcomes including 
death. Early recognition and treatment are essential, but identifying Lemierre's 
disease is challenging.