DENGUE FEVER

Definition: is a mosquito – borne viral disease widely

spread in tropical and subtropical region transmitted by
Aedes mosquitoes.

Pathophysiology:
Precipitating:
Predisposing:  Environmental conditions [Open spaces with
Geographical area water pots, and plants]
[tropical islands]  Immunocompromised
 Mosquito carrying Dengue Virus
 Soldier
 Sweaty skin

Diagnostic:
Aedes aegypti[Dengue virus carrier]: 8 – 12 days of viral replication on Hematology:
mosquitos’ salivary glands Increased WBC:
12, 900/cumm (5,000 –
Bite from mosquito (Portal of entry in skin 10,000/cumm)
Increased Lymphocytes:
49% (20 – 40%)
Allowing dengue virus to be inoculated
towards the circulation/blood [IP: 3 – 14 days]
Diagnostic:
Hematology:
Virus disseminated rapidly into the blood and Decreased Monocytes: 4%
stimulates WBCs including B lymphocytes that (8 – 14%)
produces and secretes immunoglobulins (Ab), & Decreased Neutrophils:
monocytes/ macrophages, neutrophils 49% (50 – 70%)

Ab attach to the viral Ag, and then monocytes/

macrophages will perform phagocytosis
through FcR within the cells and dengue virus
replicates in the cells Entry to the Entry to the
spleen and liver bone marrow
Recognition of dengue viral Ag on infected
monocytes by cytotoxic T – cells

Release of cytokines which consist of

vasoactive agents such as interleukins, TNF,
Urokinase and platelet activating factors which
stimulates WBCs and pyrogen release

Signs/symptoms: Febrile:
38.6°C, Diaphoresis, DENGUE FEVER
Flushed, warm skin, chills,
anorexia & vomiting;
Headache, whitish spots,
body weakness

©2018 – Lagilagi
Virus ultimately targets liver and spleen Cellular direct destruction and infection
parenchymal cells where infection of red bone marrow precursor cells as Activation of
produces apoptosis/ cell death well as immunological shortened killikrein kinin
platelets survival causing platelets lyses. system

Diagnostic: Hepatosplenomegaly
Ultrasound: Thrombocytopenia Increase vascular Tournique
minimal permiability t test (+)
hepatosplen Signs/ Symptoms:
omegaly, >Abdominal pain with Dengue Hemorrhagic
Blood 5/10 pain scale as Fever Leakage of
chemistry: verbalized. plasma
SGOT: 558.0
U/L (up to Increase number and size of Rapid weak
46) the pores in the capillaries Hypovolemia pulse,
Signs/ which leads to a leakage of narrowing
Symptoms: fluid from the blood to the of pulse
Signs/ +1 bipedal edema, interstitial fluid (capillary Shock pressure
Symptoms: weak bounding leakage) of the different and
Red sclera in both pulse hypotensio
eyes, petechiae Dengue Shock n
Syndrome

Pleural Effusion Ascites

Diagnostic: Death
Hematology:
Decreased platelet:
68,000/cumm
Recovery Complications:
Intense bleeding,
Signs/ Symptoms: pulmonary edema,
Profuse non-productive shock, very low blood
cough with white sputum pressure Liver
with blood spots noted; cirrhosism Death
shallow & rapid
respirations of 35cpm;
crackles/ rales.
Diagnostic: Signs/ Symptoms:
Ultrasound: Abdominal distension with
Diagnostic: Conclusion – abdominal girth of 93cm
Ultrasound: moderate ascites [36 inches]: hypoactive
Conclusion – bowel sounds of 3/min
Minimal bilateral
pleural effusion

©2018 – Lagilagi