Thrombocytopenia is a common feature in ICU patients which occurs usually in case of infection or septic shock. Its mechanisms, which are often unclear, include the haemophagocytic syndrome initially linked with histiocytic proliferation but probably also associated with infectious diseases. This syndrome is characterized by a phagocytosis of medullar blood cells. Reactive haemophagocytic syndrome can probably lead to thrombocytopenia in ICU patients as in this case report of a E. Coli infection.