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Severe dengue — DTM&H MCQ

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ModerateTropical viral infectionsSevere dengueDTM&H

A 19-year-old in Sri Lanka is on day 5 of dengue illness with abdominal pain, persistent vomiting, rising haematocrit and cool peripheries. What is the most appropriate treatment?

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Correct answer: ACareful isotonic intravenous fluid resuscitation

Careful isotonic intravenous fluid resuscitation is the single best answer because warning signs with haemoconcentration and shock indicate plasma leakage requiring careful fluid management. High-dose corticosteroids is plausible in a related presentation, but it is less appropriate because it does not fit the key discriminator in this vignette. The teaching point is that platelet count alone is not an indication for transfusion without bleeding or procedural need.

Reference: WHO disease outbreak guidance; UKHSA travel-associated infection guidance; CDC Yellow Book 2026