ABSTRACT
Lemierre syndrome is characterized by an acute oropharyngeal infection with septic thrombophlebitis of the internal jugular vein, anaerobic bacteremia, and multiple metastatic abscess, frequently involving lung. The most common etiologic organism is Fusobacterium necrophorum. In this case, otomastoiditis causes internal jugular vein thrombophlebitis, which complicates pulmonary septic embolism and tricuspid valve endocarditis. The patient had no underlying heart disease and wasn't injection drug user. Blood culture revealed Bacteroides fragilis group and group G beta-hemolytic Streptococcus. Pulmonary septic embolism is common complication in patient with Lemierre syndrome, but endocarditis is very rare, moreover tricuspid valve involvement. As widespread use of antibiotics, this syndrome becomes rare and typical course of the disease has changed. It leads to decrease recognition of this syndrome. But, Lemierre syndrome is potentially fatal if early diagnosis and appropriate antibiotic treatment is not followed.