Severe dengue in the ICU

Also known as Dengue haemorrhagic fever · Dengue shock syndrome · Severe dengue · DENV infection

Severe dengue in the ICU — the WHO 2009 classification (severe plasma leakage, severe bleeding, severe organ involvement) and warning signs, the three phases with the critical phase starting around defervescence, febrile-phase predictors (Sangkaew), antibody-dependent enhancement (Katzelnick), the 2025 WHO arboviral guideline (crystalloid over colloid, capillary refill and lactate to guide fluid, no corticosteroids, immunoglobulins, NSAIDs or prophylactic platelets), the fluid trials (Wills, Ngo), the Adult Dengue Platelet Study, NS1 testing and vaccines.

medium22 referencesUpdated 8 Oct 20267 min readSource-verified · Oct 2026

Checked against its sources on 8 Oct 2026

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8 MCQs

Meet the patient

A 29-year-old man returned from Bali and presents on day five of fever that has now settled. He is alert but peripherally cold, BP 96/78 (pulse pressure 18 mmHg), HR 118, capillary refill four seconds; haematocrit has risen and platelets have fallen. The fever has gone, but he is entering the critical phase — and a pulse pressure under 20 mmHg characterises dengue shock syndrome.^[2]

References22Show

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