摘要Rationale: Dengue fever is a viral infection that is spread through the bites of infected female Aedes mosquitos. It can cause life threatening complications, including dengue haemorrhagic fever (DHF) and dengue shock syndrome.Patient concerns: A 15-year-old male presented with fever and petechiae and later developed hemoptysis. Diagnosis: Dengue fever with DHF with diffuse alveolar hemorrhage. Interventions: Invasive ventilation with high positive end expiratory pressure, multiple transfusions of packed red blood cells, fresh frozen plasma, single donor platelets and inotropic support Outcomes: The patient was stabilized and discharged on minimal supplemental oxygen. Lessons: Diffuse alveolar hemorrhage, although very rare, should be considered in a patient with dengue who presents with hemoptysis. The treatment is directed at providing respiratory and circulatory support, and preventing the progression of microcirculation damage.