[Dog saliva causes rare and life-threatening infection]

Hemophagocytic lymphohistiocytosis (HLH) is a rare but life-threatening syndrome. Due to its heterogeneous presentation, nonspecific findings, and rarity, this diagnosis is often initially overlooked. This contributes to the high mortality. Early recognition in the emergency room, leading to prompt adequate treatment, can benefit the prognosis of this often devastating condition.

A 54-year-old man visited the Emergency department with shock, fever and cytopenias. Thorough further investigation lead to CapnocytophagaCanimorsusbacteraemia with secondary HLH as the cause. He was successfully treated with antibiotics, steroids and etoposide.

Consider the diagnosis of HLH in any severely ill patient with fever, multi-organ failure and cytopenias. If the diagnosis of HLH is established, it is crucial to identify and treat the underlying cause. By increasing attention to this life-threatening condition the high mortality could be decreased, as shown in this case report.