Background: A 64-year-old male presented with pain in his right lower leg and progressive swelling of the right ankle, without history of previous trauma. Further anamnesis revealed fever, anorexia and weight loss over the past few weeks. Laboratory results showed increased inflammatory parameters (CRP 203 mg/l). A lower extremity ultrasonographic examination ruled out deep venous thrombosis. A contrast-enhanced CT scan of the abdomen revealed multiple splenic infarctions.