How is circulatory failure characterized in the diagnostic criteria for severe dengue shock?

Updated: May 03, 2019
  • Author: Darvin Scott Smith, MD, MSc, DTM&H; Chief Editor: Michael Stuart Bronze, MD  more...
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Severe dengue with shock is diagnosed in cases meeting all of the above criteria plus evidence of circulatory failure, such as the following:

  • Rapid, weak pulse
  • Narrow pulse pressure (< 20 mm Hg), with increased peripheral vascular resistance (PVR) and elevated diastolic pressure
  • Hypotension
  • Cool, clammy skin
  • Altered mental status, although the patient may initially remain alert

The onset of shock may be subtle, indicated by raised diastolic pressure and increased PVR in an alert patient.

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