Predisposing factors : Precipitating factors :

 Age : 13 years old  Mosquito carrying dengue virus

 Geographical Area : lives in the mountainous  School environment- open spaces
place of Itogon, Benguet with water pots and plants

Aedes species (flavivirus carrier which includes dengue virus):

8-12 days of viral replication on mosquito’s salivary glands

Bite from mosquito (Portal of

Redness and itchiness in the
Entry in the Skin)
area

Allowing dengue virus to be inoculated

towards the circulation/blood
(Incubation Period : 3-14 days)

Virus disseminated rapidly into the blood and

stimulates WBCs including B-lymphocytes that Diagnostic :
produces and secretes immunoglobulins Hematology:
(antibodies), and monocytes/macrophages, Increased WBC:
neutrophils 13.7x10^g/L
(5-10x10^g/L)
Lymphocytes:
24.2%
(20.0 – 40.00%)
Elevated IgG and IgM

Antibodies attach to the viral antigens, and the

monocytes/macrophages will perform phagocytosis
Diagnostic : through Fc receptors (FcR) within the cells and dengue
Hematology : virus replicates in the cells
Increased monocytes :
12.6% (0.00-12.00%)
Neutrophils:
61.9% (45-70%)
Entry to the bone
Recognition of dengue marrow
viral antigen on infected
monocyte

Release of cytokines which consist of vasoactive agents

such as interleukins, tumor necrosis factor, urokinase
and platelet activating factors which stimulates WBCs
and pyrogen release
 S/S:
Febrile : T = 38.4˚C
DENGUE
Warm,flushed skin
Body weakness

Cellular direct destruction and

Diagnostic : infection of red bone marrow
Hematology : precursor cells as well as
Platelet: immunological shortened platelet
225x10^g/L
(150-400)

Thrombocytopenia

(+) petechiae
Viruses enter the CNS
Dengue Hemorrhagic Fever through a route

Hematogenous
Increase number and size of dissemination/spread
the pores in the capillaries
which leads to a leakage of
S/S:
fluid from the blood to the Undergoes local replication
(+) bipedal edema;
interstitial fluid (capillary in the skin
Bounding pulse
leakage) of the different parts
of the body

Transient viremia leading to

seeding of the reticuloendothelial
S/S: S/S: system and muscles
Productive cough but Abdominal
unable to expectorate; deep girth of 38
and rapid respirations of 30- inches; (+)
40 cpm; (+) crackles Pleural effusion Ascites Ascites/Fluid Continuous replication
Wave Test

Secondary viremia
leading to seeding of
Diagnostic: other sites, including
X-ray: Diagnostic: CNS
Minimal bilateral pleural Complications : Ultrasound:
effusion Intense bleeding Conclusion:
Pulmonary edema Moderate
Shock Ascites
Death Dengue Encephalitis

S/S:
Hemorrhage
Edema
Fever
Headache
Lethargy