What are the warning signs of severe Dengue (Dengue) fever?

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Last updated: May 4, 2025View editorial policy

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From the Research

Severe dengue fever requires immediate medical attention when warning signs appear, including severe abdominal pain, persistent vomiting, bleeding from gums or nose, blood in vomit or stool, rapid breathing, fatigue, restlessness, and cold or clammy skin, as these symptoms can lead to shock and have a high mortality rate if left untreated 1, 2. The warning signs of severe dengue fever typically emerge 3-7 days after the initial fever, as the fever begins to subside, and are characterized by increased vascular permeability and potential plasma leakage, which can lead to shock 3. Some of the key warning signs to watch out for include:

  • Severe abdominal pain
  • Persistent vomiting
  • Bleeding from gums or nose
  • Blood in vomit or stool
  • Rapid breathing
  • Fatigue
  • Restlessness
  • Cold or clammy skin
  • Sudden drop in temperature
  • Decreased urination
  • Lethargy or confusion Patients with pre-existing conditions, such as diabetes or hypertension, pregnant women, infants, and the elderly, are at higher risk of developing severe dengue and should be monitored closely 4. Prompt fluid replacement therapy in a hospital setting is essential for patients with severe dengue fever, as it can help prevent shock and reduce mortality rates 5. It is also important to note that aspirin and NSAIDs, such as ibuprofen, should be avoided as they can worsen bleeding tendencies in dengue patients 1, 2. Overall, early recognition and treatment of severe dengue fever are critical to reducing morbidity and mortality rates, and patients should seek emergency care immediately if they experience any of the warning signs.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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