A 20-year-old woman developed symptoms of pharyngitis followed by generalised skin rash and pulmonary infiltrates with cavitation. Arcanobacterium haemolyticum was identified in blood culture, which was susceptible to the antibiotics given. After initiating pathogen-directed therapy, the patient recovered completely. A. haemolyticum is a Gram-positive rod that can grow under aerobic and anaerobic conditions. The pathogen causes a characteristic haemolysis when cultured on human blood agar. A. haemolyticum causes pharyngitis and skin rash, particularly in adolescents. If the infection is not treated adequately, progression to more severe infections such as pneumonia, meningitis and sepsis can occur. The treatment of choice is a macrolide antibiotic.