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Dengue fever

Last reviewed: 21 Dec 2025
Last updated: 03 May 2024

Summary

Definition

History and exam

Key diagnostic factors

  • fever
  • skin flushing/rash
  • myalgia/arthralgia/headache
  • hemorrhagic signs
  • lethargy/restlessness
  • hepatomegaly
  • abdominal distention
  • pleuritic chest pain, dyspnea, cough
  • signs of circulatory collapse
Full details

Other diagnostic factors

  • gastrointestinal symptoms
  • upper respiratory tract symptoms
Full details

Risk factors

  • residence in/travel from dengue-endemic region within the past 2 weeks
  • children ages 1 to 5 years
  • older age
  • pregnancy
  • presence of comorbidities
  • exposure to infected blood products
  • living with uncovered water container
  • female sex
  • obesity
  • blood group O
Full details

Diagnostic investigations

1st investigations to order

  • CBC
  • liver function tests (LFTs)
  • serum albumin level
  • serology
  • reverse transcription-polymerase chain reaction (RT-PCR)
  • nonstructural protein 1 (NS1) detection
Full details

Investigations to consider

  • coagulation studies
  • chest x-ray
  • abdominal ultrasound
Full details

Emerging tests

  • reverse transcription-insulated isothermal polymerase chain reaction (RT-iiPCR)

Treatment algorithm

ACUTE

WHO group C (established warning signs)

WHO group B (developing warning signs)

WHO group A (no warning signs)

Contributors

Authors

S.A.M. Kularatne, MBBS, MD, MRCP (UK), FRCP (London), FCCP (SL)
S.A.M. Kularatne

Senior Professor

Chair of Medicine

Department of Medicine

Faculty of Medicine

University of Peradeniya

Peradeniya

Sri Lanka

Disclosures

SAMK is an author of several references cited in this topic.

Peer reviewers

John McBride, PhD, MBBS, DTM&H, FRACP, FRCPA

Professor of Medicine

James Cook University

Cairns Base Hospital Clinical School

Cairns

Australia

Disclosures

JM declares that he has no competing interests.

Michael Jacobs, MA, PhD, MBBS, FRCP, DTM&H

Consultant

Infectious Diseases

Royal Free Hampstead NHS Trust

London

UK

Disclosures

MJ declares that he has no competing interests.

Stephen Gluckman, MD

Professor of Medicine

Medical Director

Penn Global Medicine

Penn Center for Primary Care

PA

Disclosures

SG declares that he has no competing interests.

Créditos aos pareceristas

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Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

World Health Organization, Regional Office for South-East Asia. Comprehensive guidelines for prevention and control of dengue and dengue haemorrhagic fever - revised and expanded edition. 2011 [internet publication].Texto completo

World Health Organization, Special Programme for Research and Training in Tropical Diseases (TDR). Dengue: guidelines for diagnosis, treatment, prevention and control. New edition. 2009 [internet publication].Texto completo

Guo C, Zhou Z, Wen Z, et al. Global epidemiology of dengue outbreaks in 1990-2015: a systematic review and meta-analysis. Front Cell Infect Microbiol. 2017 Jul 12;7:317.Texto completo  Resumo

Simmons CP, Farrar JJ, Nguyen VV, et al. Dengue. N Engl J Med. 2012;366:1423-1432. Resumo

Centers for Disease Control and Prevention. Dengue: treatment. May 2019 [internet publication].Texto completo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
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  • Diagnósticos diferenciais

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  • Diretrizes

    • CDC Yellow Book: health information for international travel - dengue
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  • Folhetos informativos para os pacientes

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