Dengue fever is one of the major public health problems in the tropical countries and the adjacent subtropics. Dengue hemorrhagic fever (DHF) is a serious form of this disease. As this infection is becoming more and more common, the incidence of unusual presentations associated with dengue hemorrhagic fever is increasing. Except for the pleural effusions, pulmonary manifestations are highly unlikely in this disease. Acute respiratory distress syndrome (ARDS) in DHF is very rarely reported in the medical literature. We report a case of 19 year old female with DHF who presented with acute onset of breathlessness which was diagnosed to be due to ARDS according to the Berlin definition. After ruling out almost all possible causes of ARDS in this female, dengue hemorrhagic fever (DHF) was considered as the cause of this complication. The need of the hour is to make the medical practitioners in dengue fever endemic areas aware of this atypical complication of DHF so that proper diagnostic and treatment steps can be taken at the earliest possible convenience and the lives of such patients can be saved.
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