Clinical Care of Dengue

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.
A healthcare provider speaking to a patient in an exam room.

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.