Anaerobic gram-negative bacillary bacteremia and multiple septic pulmonary emboli developed rapidly in two previously healthy young men after an episode of pharyngitis. One patient developed proptosis and subsequent uniocular blindness. In both cases facial swelling was an early sign of jugular vein involvement. In patients not responding to antibiotic therapy, systemic anticoagulation or surgical venous ligation may be potentially useful as an additional therapeutic measure. Septic jugular vein phlebitis is a serious condition that requires early recognition and rapid institution of appropriate therapy.