Abstract:
Shock syndrome is a dangerous complication of dengue infection and is associated
with high mortality. Severe dengue occurs as a result of secondary infection with
a different virus serotype. Increased vascular permeability, together with
myocardial dysfunction and dehydration, contribute to the development of shock,
with resultant multiorgan failure. The onset of shock in dengue can be dramatic,
and its progression relentless. The pathogenesis of shock in dengue is complex.
It is known that endothelial dysfunction induced by cytokines and chemical
mediators occurs. Diagnosis is largely clinical and is supported by serology and
identification of viral material in blood. No specific methods are available to
predict outcome and progression. Careful fluid management and supportive therapy
is the mainstay of management. Corticosteroids and intravenous immunoglobulins
are of no proven benefit. No specific therapy has been shown to be effective in
improving survival.
