Discussion and evaluation: It is described here, a case of fatal dengue with clinical features of HPS. Though BMAT
results did not show the presence of macrophage hemophagocytosis, other laboratory features were consistent
with HPS especially marked elevation of ferritin, sCD163 and sCD25. Detection of dengue virus in the patient’s bone
marrow, fifteen days after the onset of fever was also consistent with the suggestion that the HPS is associated with
dengue virus infection.