A 28 year-old, previously healthy man was hospitalised with acute abdominal pain and a high fever. During six months the patient had suffered from severe pain in his left shoulder, left part of the thorax and over time also in the upper part of the abdomen. When hospitalised he showed biochemical signs of infection and a computer tomography of the abdomen revealed an 11 cm abscess in the spleen. Non-haemolytic streptococci were found after aspiration. Initially the abscess was treated with antibiotics and ultrasound-guided drainage. Due to lack of curative effect of drainage splenectomy was finally performed.