THBD and infection: Actually, in ours as in other cases of C. canimorsus-related septic shock, the MODS was determined by the highly prothrombotic DIC; although the trigger(s) are not precisely identified due to the unusual occurrence of this infection, it is has been hypothesized that the pathogen adhesion to the endothelium causes the upregulation of adhesion molecules and the margination of polimorphonucleates whose proteases impair the endothelial thrombomodulin that, in turn, substantially decreases the function of the proteins C (PC).