Management in patients with dengue

Nandini Chatterjee, MD, is a professor of medicine in the Institute of Post Graduate Medical Education and Research (IPGMER) in Kolkata, India, and editor in chief of the McMaster Textbook of Internal Medicine South Asia Edition.

What management strategy is currently recommended for patients with dengue fever?

The current recommendations for dengue fever are mainly based on supportive therapy because there is no definite or specific drug to treat this arboviral illness. What is very important is to maintain the fluid balance. Fluid therapy in the mild illness should be oral, whereas in the severe disease, it has to be through the intravenous route. But we should make sure that after 48 hours we should not give too much fluid, as by this we may lead to complications like heart failure and myocarditis getting aggravated.

The other therapies are taking control of the fever through acetaminophen (INN: paracetamol) and keeping a close observation on the development of complications like renal failure, myocarditis, or encephalitis. In case of renal failure, we may have to take recourse to renal replacement therapy, etc.