Multiple Cranial Nerve Palsies due to Lemierre Syndrome Associated with Atypical Streptococcus pyogenes Infection

Lemierre syndrome is an extremely rare but life-threatening condition, characterized by septic thrombophlebitis of the internal jugular vein. There is usually a preceding oropharyngeal infection, and the culprit pathogen is usually Fusobacterium necrophorum. We present an unusual case of Lemierre syndrome caused by Streptococcus pyogenes. The patient initially presented to ophthalmology with multiple cranial nerve palsies and cavernous sinus thrombosis. He was successfully treated with antibiotics in a timely fashion. This is the first report to show this pathogen causing severe ophthalmic complications from Lemierre syndrome.