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A 28-year-old Japanese woman with a fever and sore throat had been hospitalized for pneumonia, but treatments with tazobactam/piperacillin (TAZ/PIPC) and azithromycin were ineffective. She was therefore transferred to our hospital. Enhanced computed tomography revealed multiple bilateral pulmonary cavities and bilateral plural effusion (Picture 1A) and mural thrombus of the right internal jugular vein (Picture 1B) with surrounding low-density areas (Picture 1C), and a ring-shaped nodule was identified in the right thigh that was suspected of being an abscess (Picture 1D). Anaerobic blood cultures grew Fusobacterium spp., which were susceptible to almost all β-lactam antibiotics. She was diagnosed with Lemierre syndrome (1), and administration of meropenem (3 g/day) was started with bilateral chest drainage. A 16S ribosomal RNA gene analysis of the left plural effusion revealed F. necrophorum (accession

A Case of Lemierre Syndrome Complicated with Empyema