PMC4802672_01
(A) CT abdomen and pelvis with contrast. Large heterogeneous spleen and perisplenic thickening. (B) Abdominal ultrasound of the spleen. Focal 11 mm hyperechoic lesion in the spleen probably represents a hemangioma. (C) Peripheral blood smear showing red blood cell containing highly complex rings and fused forms. (D) Peripheral blood smear showing red blood cell containing round to oval shaped ring.
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CT of the abdomen and pelvis (Fig. 1A) showed moderate splenomegaly with large patchy, wedge-shaped hypodense area in posterior mid and upper spleen extending toward hilum, suggesting splenic infarction. Abdominal ultrasound (Fig. 1B) showed splenomegaly with an 11 mm hyperechoic lesion on the spleen, which probably represented a small hemangioma. Rapid malaria screening came back negative, but peripheral blood smear (Fig. 1C and D) showed 0.5% of red blood cells containing intraerythrocytic parasites suggestive of plasmodium species.