Dengue Hemorrhagic Fever Pathophysiology

Precipitating Factors Predisposing Factors

 Environmental conditions  Geographical Area
(open spaces with water (Tropical areas)
pots, and plants) DENV infection  Age
 Mosquito carrying dungue  Immunocompromise
virus
 Sweaty skin
Antibody Formation

Reinfection

Virus circulates in the

bloodstream (incubation
period of 3-14 days)

Virus replicates in Infection primarily targets the

hepatocytes and Kupffer Reticuloendothelial system
cells (dendritic cells, hepatocytes,
macrophages)

Necrosis or apoptosis in
liver. Inflammation and Production of immune
mediators Release of cytokines
stretching of the Glisson’s
capsules.

Stimulate WBC and

Pyrogens
Abdominal pain
 Activation of immune Fever
response

Histamine
Release
Viral replication Destructive actions of the
and cellular virus
destruction

Body Malaise

Cellular Damage
Endothelial Cell Dysfunction
Development of Coagulation Disorder

Increased capillary Hypoproteinemia Reduced Platelets Capillary Fragility

permeability

Pleural Effusion
Coagulopathy
Plasma Leakage
Occasional
Ascite
Epistaxis Bleeding
Disseminated
Hypovolemia Hypotension Intravascular Coagulation

Severe Bleeding
Shock

Death