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Dengue virus is a major cause of arthropod-borne viral disease in the world especially in tropical countries. Its clinical manifestation varies from mild to severe which includes Hemophagocytic lymphohistiocytosis (HLH), also known as hemophagocytic syndrome that carries extremely high morbidity and mortality rate. Bacterial and fungi coinfection in dengue may complicate the clinical manifestations and management. Initially diagnosis may become a challenge as well as it can have an unorthodox presentation. This was a case of dengue fever where the clinical course and the clinical presentation was atypical and challenging. It was also associated with multiorgan complications. It is of pertinent to establish the diagnosis and address the complications promptly as to avoid irreversible end organ damage.