- Patients with known or suspected dengue fever should have their platelet count and hematocrit measured daily from the third day of illness until 1-2 days after defervescence. Patients with a rising hematocrit level or falling platelet count should have intravascular volume deficits replaced. Patients who improve can continue to be monitored in an outpatient setting. Patients who do not improve should be admitted to the hospital for continued hydration.
- Patients who develop signs of dengue hemorrhagic fever warrant closer observation. Patients who develop signs of dehydration, such as tachycardia, prolonged capillary refill time, cool or mottled skin, diminished pulse amplitude, altered mental status, decreased urine output, rise in hematocrit levels, narrowed pulse pressure, or hypotension, require admission for intravenous fluid administration.
- Patients who are resuscitated from shock rapidly recover. Patients with dengue hemorrhagic fever or dengue shock syndrome may be discharged from the hospital when they meet the following criteria:
- Afebrile for 24 hours without antipyretics
- Good appetite, clinically improved condition
- Adequate urine output
- Stable hematocrit level
- At least 48 hours since recovery from shock
- Absence of respiratory distress
- Platelet count greater than 50,000 cells/μL
Diet
- No specific diet is necessary for patients with dengue fever.
- No dark colored foods.Acetaminophen (paracetamol) is recommended for treatment of pain and fever. Aspirin, other salicylates, and NSAIDs should be avoided.
- Patients may become dehydrated from fever, lack of oral intake, or vomiting. Patients who are able to tolerate oral fluids should be encouraged to drink oral rehydration solution, fruit juice, or water to prevent dehydration.
- Return of appetite after dengue hemorrhagic fever or dengue shock syndrome is a sign of recovery.
Activity
Bedrest is recommended for patients with symptomatic dengue fever, dengue hemorrhagic fever, or dengue shock syndrome.
- Medication
- Acetaminophen (paracetamol) is recommended for treatment of pain and fever. Aspirin, other salicylates, and NSAIDs should be avoided.