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Abstract: We report a case of Lemierre''s syndrome complicated with pulmonary septic abscesses, leading to necrotizing pneumonia. In spite of administration of appropriate antibiotics and a protective ventilation strategy, the patient had several bilateral pneumothoraces. In this setting, the mechanical ventilation was unsuccessful leading to two hypoxia-related cardiac arrests. An extracorporeal CO2 removal was then carried out for 34-days duration. The patient was weaned from mechanical ventilation on day 68. He was then transferred to the chest surgery unit on day 83. [Copyright &y& Elsevier]