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We present a 20-year-old female with Lemierre's syndrome and an associated infectious brachial plexopathy and missed septic shoulder arthritis. She subsequently presented with advanced post-infectious glenohumeral joint arthritis. At the final 12-month follow-up, substantial shoulder pain and dysfunction persisted. When Lemierre's syndrome has been diagnosed, patients with upper extremity symptoms suggestive of metastatic infection require a thorough assessment to rule out musculoskeletal involvement and site-specific intervention to prev