Abstract:
Dengue infection results in significant morbidity and mortality worldwide.
Current recommended treatment is largely supportive with careful fluid
replacement, with no specific treatment available. Although corticosteroids are
not mentioned in the WHO guidelines on the management of dengue, clinicians use
corticosteroids empirically based on the presumed immunological basis of the
complications of dengue. The evidence base for the benefit or lack of benefit of
corticosteroids in dengue is limited; previous studies have been small, with
methodological flaws, less stringent randomisation and unclear allocation
concealment, and were performed a long time ago. Studies so far have only been in
patients with shock syndrome, and the possible effects of corticosteroids on
thrombocytopenia and bleeding as well as other complications of dengue are
unknown. All previous studies have been in children; the effect of corticosteroid
treatment in adults with dengue infection has not been evaluated. The possible
beneficial effects of corticosteroids on the various manifestations of dengue
infection need evaluation by adequately powered, well designed, randomised
controlled trials.
