Complications and Risks of Dengue

Most dengue is a hard week and a full recovery. The complications to know are specific, time-bound, and - with monitoring - mostly preventable. Here is what can go wrong and when.

The central complication: plasma leakage (days 3-7)

• When the fever falls, blood vessels can start leaking plasma - this is the mechanism behind everything severe in dengue
• It announces through warning signs: severe abdominal pain, persistent vomiting, restlessness or lethargy, cold hands and feet
• Caught early, careful IV fluids manage it; missed, it progresses - which is why the monitoring window matters more than the fever itself

Dengue haemorrhagic fever and severe dengue

• Bleeding: gum bleeds, nosebleeds, easy bruising, black stools, blood in vomit, heavy periods - any of these means hospital
• Dengue shock syndrome: plasma leakage so severe that blood pressure collapses - cold clammy skin, rapid weak pulse, confusion; this is the emergency the whole monitoring system exists to prevent
• Fluid accumulation: fluid around the lungs or in the abdomen causing breathlessness

Organ involvement (less common)

• Liver: hepatitis-like inflammation - very high liver enzymes, sometimes jaundice
• Heart: myocarditis - chest discomfort, palpitations, breathlessness
• Brain: encephalopathy - confusion, seizures, extreme drowsiness
• These are uncommon but real, and they are why "just a fever" dengue still gets monitored

Prolonged recovery

• Post-dengue fatigue: weakness and low mood for 2-4 weeks after the fever - common, frustrating, and it does resolve
• Hair fall weeks later (telogen effluvium) - temporary and recoverable
• The important future risk: a SECOND dengue infection with a different serotype can be more severe than the first - past dengue makes prevention more important, not less

When to rush

Abdominal pain, persistent vomiting, any bleeding, black stools, breathlessness, cold hands and feet, confusion or extreme lethargy: hospital now - not tomorrow morning.

One-line summary

Dengue's complications are plasma leakage in the day 3-7 window, bleeding and shock if it progresses, rarer liver-heart-brain involvement, and weeks of post-fever fatigue - nearly all preventable or manageable when the warning signs are treated as the emergency they are.