Key points
- No specific medicines are available for dengue.
- Patients presenting with warning signs or severe dengue should be managed in a hospital.
- Patients managed as outpatients should be advised regarding when to return to the hospital.
- Pregnant patients have special considerations.
Treatment recommendations
- No treatment: no specific antiviral agents exist for dengue.
- Supportive care is advised: patients should be advised to stay well hydrated and to avoid aspirin (acetylsalicylic acid), aspirin-containing drugs, and other nonsteroidal anti-inflammatory drugs (such as ibuprofen) because of their anticoagulant properties.
- Fever should be controlled with acetaminophen and tepid sponge baths.
- Febrile patients should avoid mosquito bites to reduce risk of further transmission.
Severe dengue
- For patients who develop severe dengue, close observation and frequent monitoring in an intensive care unit may be required.
- Prophylactic platelet transfusions in dengue patients are not beneficial and may contribute to fluid overload.
- Administration of corticosteroids has no demonstrated benefit and is potentially harmful to patients; corticosteroids should not be used except in the case of autoimmune-related complication (e.g., hemophagocytic lymphohistiocytosis, immune thrombocytopenia purpura).
Dengue Case Management Pocket Guide
For more information, checkout the Dengue Case Management Pocket Guide.
Dengue During Pregnancy
- The potential for vertical transmission should be considered for pregnant patients with dengue who are symptomatic late in pregnancy or at delivery.
- Newborns usually develop symptoms within 14 days of birth (commonly within the first week), but most babies are asymptomatic.
- Clinical presentation in babies varies from mild common symptoms of dengue to severe dengue with shock and hemorrhagic manifestations.