Pulmonary edema developed in 3 (patients 4, 5 and 8) patients; 2 of them with DSS experienced acute pulmonary edema emerged on day 5 (patient 5) and day 6 (patients 8) after dengue onset, respectively, while the other one (patient 4) with lung cancer and hypoalbuminemia (serum albumin, 1.4 g/dL [normal range, 3.0–4.5 g/dL]) experienced septic shock on day 15 of hospitalization (day 17 after dengue onset) thus receiving fluid resuscitation, and pulmonary edema was found on following day. The gene discussed is ALB; the disease is septic shock.