Background: Lemierre's syndrome is a potentially severe though uncommon entity consisting in septic emboli from an internal jugular vein thrombus after oropharyngeal infection.
Case report: A 21-year-old man initially treated for acute pharnygeal infection developed fever and lower chest pain related to multiple pulmonary abscesses. The diagnosis of Lemierre's syndrome was retained due to the association of extensive thrombus formation in the internal jugular vein and Streptococcus intermedius septicemia.
Discussion: Lemierre's syndrome is a classical entity whose frequency is probably underestimated. The causal agent is not always an anaerobic germ. Use of anticoagulants is controversial.