Loading
Viral Infections and Outbreaks Research / Mosquito Borne Diseases and Control · Journal article
Tropical Medicine and Infectious Disease · September 8, 2026
A consensus or society position rather than new primary data.
This structured narrative review synthesizes evidence on the pathogenesis, clinical recognition, diagnosis, and management of severe dengue in children, emphasizing the role of antibody-dependent enhancement, endothelial injury, and warning signs around defervescence. The review does not report new trial data but provides an evidence-informed framework for clinicians, highlighting that standardized pediatric management with timely fluid resuscitation, serial clinical assessment, and integrated public-health strategies are central to reducing mortality in resource-limited tropical settings.
Structured narrative review. Children with severe dengue in tropical and subtropical regions.
Severe dengue reflects interactions among viral factors, pre-existing immunity, dysregulated host responses, and microvascular endothelial injury. Deterioration often occurs abruptly around defervescence; serial clinical assessment, hematocrit trends, and urine-output monitoring are central to risk stratification. Molecular assays and NS1 antigen testing are most useful during the early febrile phase, although diagnostic performance varies with illness timing and immune status.
No mortality rates, morbidity figures, or epidemiological data cited numerically. Reducing mortality requires integrated clinical and public-health strategies combining standardized pediatric management, accessible diagnostics, effective referral systems, vaccination, surveillance, and vector control.
Clinicians should recognize that deterioration in dengue can occur abruptly around defervescence and requires serial clinical monitoring including hematocrit trends and urine output. Management should balance timely isotonic crystalloid resuscitation against avoiding excessive fluid administration, and should be embedded within referral systems and public-health strategies including vaccination and vector control.
A structured narrative review synthesizing evidence on epidemiology, pathogenesis, diagnosis, and management of severe dengue in children, offering clinical recommendations but not reporting new primary data or trial results.
As stated by the source record.
Clinicians should recognize that deterioration in dengue can occur abruptly around defervescence and requires serial clinical monitoring including hematocrit trends and urine output. Management should balance timely isotonic crystalloid resuscitation against avoiding excessive fluid administration, and should be embedded within referral systems and public-health strategies including vaccination and vector control.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
What is missing. This record has no reported figures. That is a gap in the analysis, not a judgement about the study.
Severe dengue remains an important cause of pediatric hospitalization, morbidity, and mortality in tropical and subtropical regions, particularly where rapid triage and pediatric critical-care capacity are limited. This structured narrative review synthesizes evidence on the epidemiology, pathogenesis, early recognition, diagnosis, management, and prevention of severe dengue in children. Severe disease reflects interactions among viral factors, pre-existing immunity, dysregulated host responses, and microvascular endothelial injury. Antibody-dependent enhancement, inflammatory mediators, dengue nonstructural protein 1, and endothelial glycocalyx disruption contribute to vascular hyperpermeability, plasma leakage, shock, severe bleeding, and organ impairment. Because deterioration often occurs abruptly around defervescence, serial clinical assessment, hematocrit trends, urine-output monitoring, and timely recognition of warning signs are central to risk stratification. Molecular assays and NS1 antigen testing are most useful during the early febrile phase, although diagnostic performance varies with illness timing and immune status. Carefully titrated isotonic crystalloid therapy remains the cornerstone of treatment; both delayed resuscitation and excessive fluid administration may worsen outcomes. Reducing mortality requires integrated clinical and public-health strategies combining standardized pediatric management, accessible diagnostics, effective referral systems, vaccination where appropriate, surveillance, and vector control.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.