PATHOPHYSIOLOGY OF DENGUE HEMORRHAGIC FEVER Dengue infection can be acquired by: 1.

. Predisposing factor: Geographical location tropical island in the Philippines and Asia 2. Precipitating factor: Environmental conditions (open spaces, water, pots and plants) Immunocompromise Mosquito carrying dengue virus Soldier Sweaty skin Aedes aegypti (Dengue virus carrier) 8-12 days of viral replication on mosquitos salivary glands Bite of mosquito (Portal of Entry in the skin) Allowing the 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 produces and secretes antibodies and monocytes and neutrophils Antibodies attach to the viral antigens, and then monocyte/macrophages will perform phagocytosis through Fc receptor (FcR) within the cell and dengue virus replicates in the cells Recognition of dengue viral antigen on the infected monocyte Entry to the spleen and liver Entry to the bone marrow Release of cytokines which consist of interleukins, tumor necrosis factor, urokinase and platelet activating factors which stimulates WBC and pyrogen release