What are the recommended management strategies for a patient with dengue fever presenting with severe symptoms?

Management of severe dengue fever requires urgent hospital admission and close monitoring of vital signs, fluid balance, and organ function. The cornerstone of treatment is careful fluid resuscitation to manage plasma leakage and prevent shock, using isotonic crystalloid solutions initially, with cautious titration to avoid fluid overload and pulmonary oedema ¹.

Patients presenting with dengue hemorrhagic fever or shock syndromes need intensive care support, including monitoring for bleeding, maintaining haemodynamic stability, and correcting coagulopathy as needed. Blood transfusions may be required for significant hemorrhage or severe thrombocytopenia with bleeding (Ranjit and Kissoon, 2011).

Close monitoring of haematocrit and platelet counts guides fluid management and transfusion decisions. Early recognition of warning signs such as persistent vomiting, severe abdominal pain, mucosal bleeding, lethargy, or restlessness is critical to escalate care promptly ¹.

Supportive care includes oxygen therapy for respiratory distress, analgesia avoiding NSAIDs due to bleeding risk, and management of organ dysfunction such as liver or renal impairment. There is no specific antiviral treatment; management remains supportive and symptomatic (Parveen et al., 2023).

In ICU settings, invasive monitoring and vasoactive drugs may be necessary for refractory shock, and multidisciplinary care is essential to address complications. Early intervention reduces mortality and improves outcomes (Soni et al., 2001).