Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India.
Indian J Pediatr. 2023 Feb;90(2):168-177. doi: 10.1007/s12098-022-04394-8. Epub 2022 Dec 27.
Dengue is an important public health problem with a wide clinical spectrum. The World Health Organization classifies dengue into probable dengue, dengue with warning signs, and severe dengue. Severe dengue, characterized by plasma leakage, severe bleeding, or organ impairment, entails significant morbidity and mortality if not treated timely. There are no definitive curative medications for dengue; management is supportive. Judicious fluid resuscitation during the critical phase of dengue is the cornerstone of management. Crystalloids are the initial fluid of choice. Prophylactic platelet transfusion is not recommended. Organ involvement in severe dengue should be carefully looked for and managed. Secondary hemophagocytic lymphohistiocytosis is a potentially fatal complication of dengue that needs to be recognized, as specific management with steroids or intravenous immunoglobulin may improve outcomes. Several compounds with anti-dengue potential are being studied; no anti-dengue drug is available so far.
登革热是一个具有广泛临床谱的重要公共卫生问题。世界卫生组织将登革热分为疑似登革热、有预警症状的登革热和重症登革热。重症登革热的特点是血浆渗漏、严重出血或器官损伤,如果不及时治疗,会导致较高的发病率和死亡率。目前尚无针对登革热的特效治愈药物,治疗以支持性疗法为主。在登革热的关键阶段进行明智的液体复苏是管理的基石。晶体液是初始首选的液体。不建议预防性血小板输注。重症登革热的器官受累应仔细观察并加以处理。继发噬血细胞性淋巴组织细胞增生症是登革热的一种潜在致命并发症,需要加以识别,因为使用类固醇或静脉注射免疫球蛋白进行特定治疗可能会改善预后。目前正在研究几种具有抗登革热潜力的化合物,但迄今为止尚无抗登革热药物。