Severity of dengue fever

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Dengue fever can range from mild to severe, with the most severe form being dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS). Here’s a breakdown of the severity levels:

1. Mild Dengue Fever (Dengue Fever)

  • Symptoms:
  • Fever (2–7 days)
  • Headache, retro-orbital pain, muscle/ joint pain, rash
  • No signs of plasma leakage or severe bleeding
  • Rationale: This is the most common form, often self-limiting with supportive care.

2. Severe Dengue (DHF/DSS)

  • Dengue Hemorrhagic Fever (DHF):
  • Symptoms:
    • Fever, bleeding (e.g., petechiae, gum bleeding), plasma leakage (e.g., pleural effusion, ascites)
    • Thrombocytopenia (platelet count < 100,000/mm³)
    • Positive tourniquet test (20+ petechiae/2.5 cm)
  • Rationale: Occurs in patients with prior dengue infection due to antibody-dependent enhancement (ADE).
  • Dengue Shock Syndrome (DSS):
  • Symptoms:
    • All DHF signs + hypotension (systolic BP < 80 mmHg in adults, < 50 mmHg in children)
    • Cold, clammy skin, rapid pulse, narrow pulse pressure
  • Rationale: Life-threatening due to circulatory failure; requires urgent fluid resuscitation.

Key Risk Factors for Severe Dengue:

  • Prior dengue infection (increases risk of ADE)
  • Young age or advanced age
  • Co-morbidities (e.g., diabetes, heart disease)

Would you like details on diagnosis or management?