Integrating structured point-of-care ultrasound into dengue fever management: A mini review and comprehensive clinical guide.

Dengue fever is one of the most common mosquito-borne viral diseases and poses a significant health threat. The primary management involves hydration tailored to the disease stage and severity. Although many cases are mild, dengue can rapidly progress within hours. Complications such as plasma leakage and bleeding are difficult to detect through routine clinical assessment alone. In this context, point-of-care ultrasound (POCUS) has emerged as a valuable bedside tool for the early detection of fluid shifts and plasma leakage. Ultrasound findings in dengue-related plasma leakage include gallbladder wall thickening, ascites, pleural effusions, and other third-space fluid shifts. These sonographic signs often precede the clinical presentation of plasma leakage and can serve as early indicators for impending shock. Regular ultrasound assessment facilitates risk stratification and timely intervention, potentially reducing progression to dengue shock syndrome. Currently, there is no validated POCUS protocol specific to dengue assessment. We propose a standardized, structured ultrasound protocol focusing on key diagnostic parameters, coupled with serial serum hematocrit and lactate measurements for a comprehensive evaluation. This approach facilitates earlier identification of at-risk patients, thereby improving patient management, preventing clinical deterioration, and reducing morbidity and mortality associated with severe dengue.