Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- fever
- skin flushing/rash
- myalgia/arthralgia/headache
- haemorrhagic signs
- lethargy/restlessness
- hepatomegaly
- abdominal distension
- pleuritic chest pain, dyspnoea, cough
- signs of circulatory collapse
Other diagnostic factors
- gastrointestinal symptoms
- upper respiratory tract symptoms
Risk factors
- residence in/travel from dengue-endemic region within the past 2 weeks
- children aged 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
Diagnostic investigations
1st investigations to order
- FBC
- liver function tests (LFTs)
- serum albumin level
- serology
- reverse transcription-polymerase chain reaction (RT-PCR)
- non-structural protein 1 (NS1) detection
Investigations to consider
- coagulation studies
- chest x-ray
- abdominal ultrasound
Emerging tests
- reverse transcription-insulated isothermal polymerase chain reaction (RT-iiPCR)
Treatment algorithm
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)

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 monograph.
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.
Differentials
- Zika virus infection
- Chikungunya virus infection
- Rickettsial diseases
More DifferentialsGuidelines
- Laboratory testing for Zika virus and dengue virus infections
- Guidelines for the diagnosis and treatment of Dengue in China
More GuidelinesPatient leaflets
Dengue fever
More Patient leafletsVideos
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