Dengue fever

Last reviewed: 4 Sep 2022
Last updated: 01 Sep 2022

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
More key diagnostic factors

Other diagnostic factors

  • gastrointestinal symptoms
  • upper respiratory tract symptoms
Other diagnostic factors

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
More risk factors

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
More 1st investigations to order

Investigations to consider

  • coagulation studies
  • chest x-ray
  • abdominal ultrasound
More investigations to consider

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 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.

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