Abstract
Isolated splenic sarcoidosis is a rare entity, but clinicians should consider it in patients with compatible clinical features. Its diagnosis is challenging due to the broad differential diagnosis, which includes hematologic and splenic neoplasms, infiltrative and inflammatory disorders, autoimmune diseases, and infections. We report the case of a 15-year-old female diagnosed with isolated splenic sarcoidosis during hospitalization for fever of unknown origin. Histopathological examination revealed non-caseating granulomas and necrotizing granulomas. The patient showed marked clinical and radiological improvement following corticosteroid therapy, supporting the diagnosis. Despite its atypical presentation, this case highlights the importance of including sarcoidosis in the diagnostic evaluation of prolonged fever, even in young patients without respiratory symptoms.