No good evidence that corticosteroids are helpful in dengue shock syndrome

The dengue virus is transmitted by mosquitoes and can cause either a mild illness with fever or a more severe illness with fever and bleeding (dengue haemorrhagic fever). The bleeding is generally seen as tiny red spots on the skin but can occasionally be more severe affecting the nose, gums, and gut. In its most severe form it can cause shock, collapse, and sometimes death (dengue shock syndrome). The current treatment for dengue shock syndrome is to give fluids directly into the bloodstream, but corticosteroids have been suggested as drugs that may help due to their anti-inflammatory properties. This review of trials found only four small trials (with 284 participants) that were not of good quality and which showed no benefit overall. Further trials would be needed before this drug were used in these patients, as there is the potential for adverse effects due to the drugs' properties of suppressing the immune system and potentially leaving people open to other infections.