Atypical Lemierre's syndrome with pleural infection

A 25-year-old woman presented to the emergency department with dyspnea after recent sore throat and failed antibiotic treatment. Point-of-care lung ultrasound revealed consolidation and pleural effusion, and cultures grew Fusobacterium necrophorum. CT showed no thrombosis in the internal jugular vein. The case highlights atypical Lemierre’s syndrome, the value of history-taking, point-of-care ultrasound, and early pleural aspiration.