Lemierre syndrome is a life-threatening condition associated with infection by 
obligate anaerobes residing in oropharyngeal mucosa. The most common organism 
responsible is Fusobacterium necrophorum. We report a case in a 69-year-old 
gentleman. The man with past medical history of hypertension, anxiety and 
chronic alcohol abuse was brought in by his family for altered mental status and 
fever. He had a complicated stay with septic shock on multiple pressors, his 
blood cultures grew Fusobacterium necrophorum and neck ultrasound showed acute 
thrombus of the right internal jugular vein (IJV). The patient had received 
intravenous antibiotics throughout stay but had poor prognosis and eventually 
expired after a complicated hospital stay. Lemierre syndrome is a rare syndrome 
usually associated with an acute oropharyngeal infection due to anaerobic 
bacteria leading to secondary septic thrombophlebitis of the internal jugular 
vein. The characteristic clinical picture noticed is a hematogenous progression 
to distant septic emboli. It is a life-threatening condition and a prompt 
diagnosis is critical for preventing fatal consequences. The purpose of this 
case report is to increase awareness about this clinical condition among medical 
professionals.