PATHOPHYSIOLOGY

Predisposing factors Precipitating factors

>geographical area – tropical >environmental conditions
>immunocompromised
>presence of mosquitoes carrying dengue virus
>sweaty skin

Aedes aegypti bites the host, injecting the virus

S/S:
>redness
>itchiness in the area

Virus incubates in the circulation for 3-14 days

Virus disseminates rapidly into the blood

Stimulation of the WBC which includes B

lymphocytes which produces and secretes Ig,
monocytes/macrophages, and neutrophils
Diagnostic - Hematology
>increased WBC – around 12,900/mm 3 (Normal: 5,000-10,000/mm3)
>increased lymphocytes – 49% (Normal: 20-40%)

Antibodies attach to the viral antigens, and then

macrophages perform phagocytosis within the
cells and dengue virus replicate in the cells
Diagnostic - Hematology
>decreased monocytes 4% (Normal: 8-14%)
>decreased neutrophils – 49% (Normal: 50-70%)

Recognition of dengue viral antigen on

monocyte

Release of cytokines which consist of vasoactive

agents such as interleukins, tumor necrosis
factor, urokinase, and platelet activating factor
which stimulate WBCs and pyrogen release

Entry to spleen Entry to bone

Entry to spleen marrow

Dengue
S/S
>febrile – 38.6°C
>flushed skin, warm to touch
>diaphoresis
>headache
>whitish spots
> body weakness
Virus ultimately targets liver and spleen Cellular direct destruction and infection of
parenchymal cells where infection red bone marrow precursor cells
produces apoptosis/cell death

Hepatosplenomegaly Thrombocytopenia
S/S S/S
>abdominal pain >reddish sclera in both eyes
Diagnostic – UTZ >petechiae
>minimal hepatosplenomegaly Diagnostic – Hematology
Diagnostic – Blood Chem >decreased platelet
>SGOT – 558.0
>U/L – Up to 46 Dengue Hemorrhagic Fever

Increase number and size of the pores in the

capillaries which leads to a leakage of fluid
from the blood to the interstitial spaces
S/S
>+1 bipedal edema
>weak bounding pulse

Pleural effusion Ascites

S/S S/S
>profuse nonproductive cough with >abdominal distention
white sputum with blood spots noted >hypoactive bowel sounds
>shallow and rapid respiration
>crackles/rales

Recovery Complications:
>intense bleeding
>pulmonary edema
>shock
>very low BP
>liver cirrhosis
>death