Introduction:

Hemophagocytic syndrome is a severe clinical picture with an uncontrolled inflammatory reaction caused by an inadequate immune system response to an infectious, neoplastic, rheumatological, or metabolic trigger. The syndrome has low incidence but high fatality when the management is not adequate.

Objective:

To highlight the importance of a prompt diagnosis of hemophagocytic syndrome in patients with dengue who present a torpid evolution.

Case presentation:

Seven-year-old patient with severe dengue caused by shock, hepatomegaly with elevated transaminase levels and poor clinical evolution who meets hemophagocytic syndrome criteria. The patient had satisfactory progression after receiving immunomodulatory treatment.

Conclusions:

Hemophagocytic syndrome must be considered as a cause of pathologies in dengue patients with torpid evolution, even when correct medical management is made.

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