It all started with a sore throat: Polymicrobial septicaemia, cavitating lung lesions and severe thrombocytopenia.

We report a case of a syndrome first described by French bacteriologist Andre Lemierre nearly one hundred years ago. A young woman presented with fever, chest pain and arthralgia. Admission investigations revealed thrombocytopenia, cavitating pneumonia and an internal jugular vein thrombus. Blood cultures were positive for Fusobacterium necrophorum and Streptococcus constellatus. Respiratory failure developed within 48hrs and was managed with high flow nasal oxygen in a critical care setting. Discussed are the investigation findings leading to diagnosis, as well as the antimicrobial and anticoagulation management strategies. Lemierre's syndrome is rarely encountered by non-specialists but a good outcome can be expected with prompt diagnosis and treatment.