What are the signs and symptoms of dengue (Dengue) fever?

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Last updated: April 28, 2025View editorial policy

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From the Guidelines

Dengue fever typically presents with symptoms such as high fever, severe headache, pain behind the eyes, muscle and joint pain, nausea, vomiting, swollen glands, and rash, usually appearing 4-10 days after infection. The main signs and symptoms of dengue fever can be summarized as follows:

  • High fever (104°F/40°C)
  • Severe headache
  • Pain behind the eyes
  • Muscle and joint pain (often called "breakbone fever")
  • Nausea
  • Vomiting
  • Swollen glands
  • Rash, which usually appears 2-5 days after the onset of fever and spreads from the trunk to the limbs and face These symptoms occur because the dengue virus, transmitted by Aedes mosquitoes, causes increased capillary permeability and abnormal blood clotting mechanisms 1. According to the most recent guidance, patients with clinically suspected dengue should receive appropriate management to monitor and treat shock and hemorrhage, and women with laboratory evidence of possible Zika virus infection during pregnancy and their infants should be evaluated and managed for possible adverse outcomes 1. The most important aspect of managing dengue fever is early recognition of symptoms, as there is no specific antiviral treatment, and treatment focuses on managing symptoms with acetaminophen, rest, and adequate fluid intake. Warning signs that require immediate medical attention include severe abdominal pain, persistent vomiting, bleeding, lethargy, or liver enlargement 1. It is essential to note that dengue fever can be diagnosed using nucleic acid amplification tests (NAATs) and immunoglobulin M (IgM) antibody testing, but interpreting the results can be complicated by cross-reactivity, and determining the specific timing of infection can be difficult 1.

From the Research

Signs and Symptoms of Dengue Fever

  • Dengue infection can result in a diverse range of symptoms, from mild undifferentiated fever to life-threatening hemorrhagic fever and shock 2
  • Clinical manifestations of dengue can range from asymptomatic infection to severe infection with multi-organ failure 3
  • Dengue haemorrhagic fever (DHF) is a subcategory in dengue infection with a hallmark of plasma leak (ie critical phase) 3
  • Dengue fever may present with extended and unusual manifestations affecting any organ, including the heart, liver, kidney and brain 3
  • Symptoms can include fever, pain, and hemorrhagic manifestations, with severe cases leading to dengue shock syndrome, which can be fatal 4

Common Symptoms

  • Fever 2, 3, 4
  • Pain 5, 4
  • Hemorrhagic manifestations 2, 3, 4
  • Plasma leak 3
  • Thrombocytopenia 5

Severe Symptoms

  • Hemorrhagic fever 2, 3, 4
  • Shock 2, 3, 4
  • Multi-organ failure 3
  • Dengue shock syndrome 4

References

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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