From the Guidelines
Dengue fever treatment should focus on relieving symptoms and providing supportive care, with an emphasis on fluid resuscitation and monitoring for warning signs of severe dengue. Patients should rest, drink plenty of fluids to prevent dehydration, and take acetaminophen (Tylenol) for fever and pain relief at a dose of 500-1000mg every 6 hours, not exceeding 4000mg daily for adults 1. Importantly, avoid aspirin, ibuprofen, and other NSAIDs as they can increase bleeding risk in dengue.
Key Considerations
- Monitor for warning signs of severe dengue, including severe abdominal pain, persistent vomiting, bleeding gums, rapid breathing, fatigue, restlessness, or blood in vomit.
- Patients with these symptoms or signs of dehydration should seek immediate medical care, as severe dengue may require hospitalization for intravenous fluids, blood pressure monitoring, and possibly blood transfusions.
- Use crystalloids and/or colloids for fluid resuscitation, with colloid solutions considered for children with severe Dengue shock syndrome 1.
- Dopamine or epinephrine (adrenaline) should be used in patients with persistent tissue hypoperfusion despite liberal fluid resuscitation 1.
- In patients requiring dopamine or epinephrine (adrenaline), measure arterial blood pressure and heart rate frequently 1.
- Administer intravenous hydrocortisone (up to 300 mg/day) or prednisolone (up to 75 mg/day) to adult patients requiring escalating dosages of epinephrine (adrenaline) or dopamine 1.
Prevention and Control
- Prevention through mosquito control remains the best approach to dengue management.
- Apply oxygen to achieve an oxygen saturation ≥ 90% 1.
- Place patients in a semi-recumbent position (head of the bed raised to 30–45°) 1.
From the Research
Dengue Fever Treatment Overview
- Dengue fever treatment is primarily supportive, with a focus on fluid management and symptomatic relief 2, 3, 4.
- The goal of treatment is to prevent complications, such as dengue shock syndrome (DSS), and to reduce mortality 2, 5.
Fluid Management
- Crystalloid solutions, such as normal saline or Ringer's lactate, are commonly used for fluid management in dengue fever patients 2, 5.
- Colloid solutions may be used in severe cases, but they carry a greater risk of adverse events 5.
- The choice of fluid management depends on the patient's hemodynamic status and the presence of complications, such as pulmonary edema 2.
Symptomatic Treatment
- Symptomatic treatment, such as pain management and antipyretics, may be used to relieve symptoms and improve patient comfort 3, 4.
- Blood transfusions may be necessary in patients with severe hemorrhage 3.
Prevention and Control
- Prevention and control measures, such as vaccination and mosquito bite avoidance, are essential in reducing the spread of dengue fever 3, 6.
- Early detection and treatment of dengue fever can significantly improve patient outcomes and reduce mortality 6.