HFS diagnosis is made basing on clinical and histological criteria. Five out of 8 criteria must be fulfilled. Absence of hemophagocytosis does not exclude the diagnosis [2] . Multiorgan failure is the most severe presentation of HFS. In pediatrics, multiorgan failure is usually caused by sepsis. In the present case, the initial diagnosis was septic shock. Therefore, HFS has to be included between the causes of multiorgan failure in pediatrics to permit an early diagnosis and treatment. Central nervous system (CNS) is often involved, which has been linked with a poor prognosis [14] . Even though our patient developed a very severe form of HFS, there seemed to be no CNS involvement, and this agrees with the good outcome.