A man in Germany has died and his dog is being blamed for his passing. The dog didn’t bite or attack the man in any way, it simply licked him. The bizarre story is the subject of a new paper in the European Journal of Case Reports in Internal Medicine, and it’s an important warning for pet owners.

The man first went to the doctor after experiencing three days of fever and difficulty breathing. His condition continued to deteriorate as medical staff attempted to determine the source of his symptoms. Ultimately his doctors narrowed it down to a simple lick from his only pet, a dog.

The man had an infection of Capnocytophaga canimorsus, a bacteria common in pets that can lead to infections in humans. It’s rare for an infection to occur, but when it does, it’s typically after a bite. This is more likely to occur in people with compromised immune systems. The fact that this individual was not bitten, but merely licked, and that he was otherwise in good health makes it a particularly odd case.

Once doctors detected the bacteria they boosted the antibiotic regimen the man had already been on for four days. His condition continued to deteriorate, and the infection spread across his body, consuming his limbs and leading to tissue death across his arms and legs. His brain began to swell and scans of his abdomen revealed that blood flow was being cut off from some organs. His family and the doctors decided to cease treatment and the man succumbed to his infection 16 days after treatment began.

The medical staff emphasizes that this case should be used as a warning to pet owners and doctors alike:

Pet owners with flu-like symptoms should urgently seek medical advice when their symptoms exceed those of a simple viral infection, which in this case were severe dyspnoea (labored breathing) and petechiae (bleeding beneath the skin). Physicians confronted with such patients should ask about contact with dogs and cats.

Such cases are, again, incredibly rare. Still, having a dog or cat does put you at a unique medical risk, and that’s something that all pet owners should understand.