When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Dengue fever

Last reviewed: 4 Apr 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 tests

1st tests 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

Tests 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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

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].Full text

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].Full text

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.Full text  Abstract

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

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

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Dengue fever images
  • Differentials

    • Zika virus infection
    • Chikungunya virus infection
    • Rickettsial diseases
    More Differentials
  • Guidelines

    • CDC Yellow Book: health information for international travel - dengue
    • Laboratory testing for Zika virus and dengue virus infections
    More Guidelines
  • Patient information

    Dengue fever

    More Patient information
  • Videos

    Venepuncture and phlebotomy: animated demonstration

    Peripheral intravascular catheter: animated demonstration

    More videos
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer