Fusobacterium nucleatum is an anaerobe that is commensal to the human oral cavity. It is usually a component of periodontal plaque that is emerging as a pathogen and quickly attracting attention of the medical and research communities. It has been even discovered in bronchoalveolar lavage of some patients with lung cancer. 24, 25 Lemierre’s syndrome (LS) is characterized as septic thrombophlebitis of the internal jugular vein, which usually begins with oropharyngeal infection that worsens and lead to inflammation of the wall of the jugular vein9 . This is the hallmark of the disease. However, in this case, there was no thrombophlebitis of the internal jugular vein. There is one other case presentation where it was diagnosed without the internal jugular vein involvement.22. Most sequelae involve infected thrombus of the vein, soft tissue inflammation, persistent bacteremia, and septic emboli, often leading to frequent metastatic infections14,3. Interestingly enough, in the age of SARS-CoV-2, LS has also been mistaken for multisystem inflammatory syndrome in children (MIS-C)23. We present a previously healthy 20-year-old female college student, who tested positive to COVID-19 capsid antibody, transferred from her local hospital to Bristol Meyer’s Squib Children’s hospital (BMSCH) for suspected LS with loculated infected pleural effusions and necrotizing pneumonia with lung abscess secondary to Fusobacterium nucleatum, systemic and emphysematous osteomyelitis possibly secondary to septic emboli, thrombocytopenia, and palatine tonsil and thyroid abscess.