Dengue fever is a mosquitoborne infectious disease endemic in over 100 countries around the world with its incidence growing in a progressive manner in the last five decades. Is cause of thousands to millions hospital admissions with a gargantuan economic burden and high mortality rate. Among the complications that dengue can cause the Hemophagocytic Lymphohistiocytosis is one of great concern since it’s a complex and severe hyperinflammation status that mimics the same cause of its expression making it difficult to catch and retarding his proper recognition and treatment. Hereby we document a case of this disease expressed on a previously healthy 6 year-old female patient whose dengue infection was so severe that needed intensive care management with vasoactive drugs and diuretics. After a short period of wellness began newly with fever, pancytopenia, hepatitis, and inflammatory response symptoms. A Dengue associated Hemophagocytic Lymphohistiocytosis syndrome was suspected and treated with intravenous corticosteroids on a 3-day scheme at no signs of malignancy with excellent response. The health care professionals must know about this not novel entity in order to reach an efficient diagnosis and treatment mostly, but not only, those in tropical and sub-tropical regions of the word were dengue virus is endemic.