Dengue Shock Syndrome: What It Is and How It Can Be Fatal

Dengue Shock Syndrome (DSS) is a severe and life-threatening complication of dengue infection, occurring in a minority of patients but carrying high risk of death if untreated. Dengue itself is caused by a virus transmitted by mosquitoes and typically presents with high fever, headaches, muscle and joint pain, and rash. Most patients recover within a week, but some develop severe symptoms 3-7 days after initial infection.

In DSS, the dengue virus causes damage to blood vessels, making them leaky and fragile. This leads to plasma leakage, where fluid escapes from blood vessels into body cavities, causing hemoconcentration and fluid buildup such as pleural effusions and ascites. Severely low platelet counts impair the blood’s clotting ability, resulting in bleeding manifestations such as bleeding gums, nosebleeds, bruising, and gastrointestinal bleeding.

The hallmark of dengue shock syndrome is a sudden drop in blood pressure, known as circulatory collapse or shock, causing inadequate blood flow to organs. This leads to multiorgan failure, including heart, liver, kidney, and brain dysfunction. Warning signs include severe abdominal pain, persistent vomiting, restlessness, pale and cold skin, rapid breathing, and confusion.

Without prompt medical intervention focusing on fluid replacement and intensive care, DSS can rapidly progress to irreversible shock and death, often within 8 to 24 hours of symptom onset. Mortality is significantly reduced in specialized treatment centers but remains high if care is delayed.

In summary, dengue shock syndrome is the most severe form of dengue, where virus-induced blood vessel damage, plasma leakage, and low platelets combine to cause life-threatening shock and organ failure. Early recognition and urgent treatment are essential to save lives in these critical cases.