An article published in Cham (CH): Springer summarized recommendations on important aspects of the management of patients with severe malaria and severe dengue. 

It was stated that severe falciparum malaria requires rapid parasitological diagnosis and prompt initiation of parenteral artesunate. 

Fluid bolus therapy should be avoided in patients without hypotensive shock. 

Initial (24 h) crystalloid fluid therapy of 2-4 mL/kg/hour is recommended, which may subsequently be reduced to 1 mL/kg/hour, in those receiving additional fluids. 

In patients presenting with hypotensive shock, fluid bolus therapy (30 mL/kg) with an isotonic crystalloid is indicated, along with an early initiation of vasopressor support. 

Enteral feeding in non-intubated adults with cerebral malaria, should be started after 60 hours to avoid aspiration pneumonia. 

The diagnosis of severe dengue involves testing of a combined dengue antigen (NS1) and antibody RDT.

Dengue shock results from capillary leakage, while hemorrhage or depression of myocardial contractility are contributing factors. 

No antiviral treatment is currently available. The World Health Organization guidelines (WHO) recommends restoration of circulation guided by pulse pressure, capillary refill time, hematocrit, and urine output. 

Large (>15 mL/kg) rapid (<30 min) fluid boluses should be avoided, but prompt fluid administration with crystalloids is essential—which should be restricted as soon as the critical phase passes—to avoid pulmonary edema. 

Corticosteroids are not recommended, neither is platelet transfusion for thrombocytopenia in the absence of active bleeding or other risk factors.

Source: Cham (CH): Springer. 2019. Chapter 9. Available from:https://www.ncbi.nlm.nih.gov/books/NBK553810/ doi: 10.1007/978-3-030-03143-5_9