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To the Editor: The recent report on “Hemophagocytic lymphohistiocytosis (HLH) and dengue in pediatric popultation” is very interesting [1]. Raju et al. concluded that dengue with multi-organ dysfunction is commonly concurrent to HLH in the marrow and hence, an early diagnosis based on clinical, laboratory and bone marrow evaluation is significant [1]. In fact HLH is an uncommon but forgotten problem that can be seen in a patient with dengue [2, 3]. This condition can be fatal and early diagnosis is needed. However, it should be noted that HLH can be due to other conditions such as sepsis [4, 5]. In the present report, as a retrospective study, Raju et al. failed to rule out the effect of possible concomitant disorder. As Raju et al. noted that the problem is common in cases with multiple organ dysfunction [2], it is expected that there might be many cases with sepsis.

Hemophagocytic Lymphohistiocytosis Syndrome in Dengue Hemorrhagic Fever: Correspondence