Hemophagocytic Lymphohistiocytosis in a Patient with Dengue Hemorrhagic Fever

HLH is an uncommon, fatal complication of dengue infection and often leads to multi-system involvement and failure. Early recognition and prompt initiation of appropriate immunosuppressive therapy is crucial in improving the outcome. We report a case who developed secondary HLH following dengue haemorrhagic fever. An 8 year and 5-month-old child who was managed as dengue haemorrhagic fever, had persistent fever, hepatosplenomegaly, bicytopenia, hyper-ferritinemia (> 20000), and hypertriglyceridemia. He was diagnosed with HLH according to the diagnosis criteria. This child was treated with steroids and supportive care following which the child made a gradual recovery. Second-line immunosuppressive treatment was not required in this case. Once sepsis is excluded, HLH should always be suspected early in this type of patient. Early appropriate immunosuppressive treatment is important to improve the long term outcome and prevent mortality.