We present here a fatal case of dengue with clinical and
laboratory findings suggesting the involvement of HPS
and evidence supporting dengue virus infection of the
bone marrow, detectable even on day 15 after the onset
of fever. These findings emphasized HPS as a serious
complication of dengue and that dengue virus persisted
in the bone marrow long after viremia is over. A reliable
treatment strategy for combating dengue-associated
HPS, however, is yet to be established. Early detection of
HPS biomarkers and treatment with methylprednisolone
or dexamethasone at appropriate dosage may prevent
further complications and death (Mitra and Bhattacharya
2014; Wan Jamaluddin et al. 2015) but this requires further
investigation.