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Precipitating

Environmental conditions (open spaces with


Predisposing water pots, and plants)
Geographical area – tropical islands Immunocompromise
in the Pacific (Philippines) and Asia Mosquito carrying dengue virus
Soldier
Sweaty skin

Aedes aegypti (dengue virus carrier): 8-12 days of viral


replication on mosquitos’ salivary glands

Bite from mosquito (Portal of Entry in the Skin) Redness & itchiness in the area

Allowing dengue virus to be inoculated


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

Virus disseminated rapidly into the blood and stimulates Diagnostic:


WBCs including B lymphocytes that produces and secretes Hematology :
immunoglobulins (antibodies), and monocytes/macrophges, Increased WBC: 12,900/cumm
neutrophils (5,000- 10,000/cumm)
Increased Lymphocytes: 49%
(20-40%)
Diagnostic:
Hematology :
Decreased Antibodies attach to the viral antigens, and then
Monocytes: 4%(8- monocytes/macrophages will perform
phagocytosis through Fc receptor (FcR) within the
14%)
cells and dengue virus replicates in the cells of
Decreased monocytes/macrophages
Neutrophils:
49%(50-70%) Entry to the spleen, Entry to the bone
and liver marrow

Recognition of dengue viral antigen on infected


monocyte by cytotoxic T cells

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

Signs/ symptoms:
Febrile: 38.6C
Diaphoresis, warm skin, Dengue Fever
flushed; headache of 3/10 pain
scale; whitish spots; body
weakness
Virus ultimately targets liver and Cellular direct destruction and infection of
spleen parenchymal cells where red bone marrow precursor cells as well as
infection produces apoptosis/cell immunological shortened platelet survival
death causing platelet lyses

Diagnostic: Diagnostic:
Ultrasound: Hematology :
minimal hepatospleno Decreased Platelet:
megaly Hepatosplenomegaly Thrombocytopenia 68,000/cumm (150,000-
400,000)
Blood Chemistry:
SGOT: 558.0 U/L(Up to
46) Signs/ symptoms:
SGPT:433.3 U/L(Up to Signs/ symptoms: Dengue Hemorrhagic Fever Red sclera in both
40) >Abdominal pain eyes
Protein: 5.2g/dL (6.6-8.7) with 5/10 pain Petechiae
Albumin:2.3g/dL (3.5- scale as
5.5)
verbalized. Increase number and size of the
pores in the capillaries which leads Signs/ symptoms:
to a leakage of fluid from the blood +1 Bipedal
to the interstitial fluid (capillary edema; weak
leakage) of the different organs bounding pulse of
Signs/ symptoms: 79bpm
and skin
Profuse non-productive cough
with white sputum with blood
spots noted; shallow & rapid Signs/ symptoms:
respirations of 35cpm; Abdominal distention with
crackles/rales
Pleural effusion Ascites abdominal girth of 93cm
(36.6 inches); hypoactive
bowel sounds of 2/min

Diagnostic:
Ultrasound:
Conclusion:
Minimal bilateral pleural Diagnostic:
effusion. Recovery Complications: Ultrasound:
Intense bleeding Conclusion:
Pulmonary Edema
Shock
Moderate ascites
Very low blood pressure
Liver cirrhosis
Death