Well known complications related to cocaine use are myocardial insufficiency, myocardial infarction, myocarditis, aortic dissection, neurologic damages, ischemic colitis, thrombotic phenomenons, renal infarction and acute liver failure. Cases of splenic infarctions related to cocaine use are extremely rare. A 17-year-old drug addict was found by her boy-friend liveless in her bed. She was well known using cocaine since years. Autopsy revealed multiple splenic infarctions with secondary mixed bacterial infection and abscesses. Petechial bleedings were found and microabscesses in the myocardium, the meninges and the kidneys. The absolutely rare bacterial infection of the cocaine-associated splenic infarction leads to sepsis with lethal course.