Dengue infection causes significant morbidity and mortality worldwide.
Therapeutic options for severe thrombocytopaenia and shock syndrome, the main
causes of mortality, are limited. Careful fluid management is the mainstay of
treatment. The immunological basis of the life-threatening manifestations of
severe dengue together with the potentially beneficial immunomodulatory effects
of intravenous immunoglobulins (IVIG) suggest a possible place for treatment with
this expensive therapy. Trials so far have not shown significant benefit in terms
of survival or improvement in clinical parameters with IVIG. However, evidence is
very limited, and there is clearly a place for well-designed randomized
controlled trials investigating the beneficial effects of IVIG in the various
life-threatening manifestations of dengue.