Abstract
Objectives: To describe the epidemiology, clinical features and treatment of dengue fever and dengue shock
syndrome.
Sources: To prepare this review, a literature search was made on Pubmed and on the World Health Organization
(WHO) and PAHO websites using the terms dengue and dengue shock syndrome. This information was complemented
with personal practice.
Summary of the findings: Dengue is the most important arthropod-borne viral disease of humans. Its
presentation is protean and varies from an undifferentiated viral syndrome to hemorrhagic fever and severe shock.
Dengue fever is a self-limiting, nonspecific illness characterized by fever, headache, myalgia, and constitutional
symptoms. Its severe forms (hemorrhagic fever and shock syndrome) may lead to multisystem involvement and
death. Early diagnosis, close monitoring for deterioration and response to treatment are necessary in all cases. WHO
has provided a stepwise approach to management that is useful for milder forms and early shock. In the more severe
forms aggressive fluid resuscitation and support for failing organs is necessary for the critically ill patient. Research
addressing pathophysiological differences between dengue shock and septic shock, choice of fluids, inotropes and
techniques of organ support are likely to yield benefits for the critically ill.
Conclusions: There is no specific therapy for dengue infections. Good supportive care may be lifesaving, but
ultimately initiatives aimed at vector control and prevention of mosquito bites may provide the greatest benefits.