Splenic Necrosis as a Rare Complication of Dengue Fever W e recently encountered a rare case of sple- nic necrosis complicating dengue fever in a young male. The diagnosis was suggested based on the sonographic and power Doppler findings. A 20-year-old male presented with fever, headache, and abdominal pain of 5 days' duration. Examination revealed hepatosplenomegaly. His total leukocyte count (TLC) was 8400 cells/mm 3 with a platelet count of 20,000 cells/mm 3 . Anti-Dengue IgM antibody was tested positive. Sonographic (US) of the abdomen was performed, which revealed hepatosplenomegaly with normal splenic and liver echotexture. On the 3rd day of his admission, he complained of left hypochondrial pain radiating to the left shoulder. Repeat TLC showed 18,700 cells/mm 3 (neutrophils 62% and lymphocytes 30%). US of the abdomen showed splenomegaly with hypoechoic areas seen in the periphery (Figure 1A) with no color flow on power Doppler imaging, suggestive of necrosis (Figure 1B). There was no perisplenic collection. Patient was treated symptomatically. Splenic necrosis is usually secondary to compromised flow in the main splenic artery, such as torsion of the splenic pedicle or thrombosis of the splenic artery. It has also been documented in Wegener's Granulomatosis. 1 Though splenic rupture following dengue fever has been described, 2 splenic necrosis has never been reported before as a complication of dengue fever. In our case, the diagnosis was suggested solely based on the US and Doppler findings. Although we felt the appearance on US and Doppler supported with the clinical presentation was specific for necrosis, further evaluation with CT was recommended, but the patient refused additional investigations.