Abstract
Dengue-associated hemophagocytic lymphohistiocytosis (HLH) is a rare presentation that can be potentially life-threatening, characterized by excessive activation of the immune system. This case report highlights the complexity of the presentation and management of a patient with multiple comorbidities who developed severe complications following a diagnosis of dengue fever. The patient presented with a persistent fever and abdominal pain alongside worsening renal and liver function. The combination of elevated serum triglyceride and ferritin levels, along with bicytopenia and the presence of splenomegaly, eventually led to a diagnosis of HLH. The patient required intensive care support, including hemodialysis, blood transfusions, and oxygen therapy. Treatment for HLH was initiated with high-dose dexamethasone and plasmapheresis, aiming to control the overactive immune response. This case highlights the need for awareness of HLH as a complication of dengue fever and emphasizes the significance of early diagnosis and treatment. It also stresses the need for further research to improve diagnostic and management strategies for HLH in dengue-endemic regions.