Predisposing Factor:

Dirty environment, age, seasons, males, geographic areas

History taking (history of exposure)

Cattle, swire and other livestock

Dogs

Rodents, wild animals

Infected urine or carcasses

Ingestion of contaminated food and water

Man

Entry through eyes, nose and broken skin

Asymptomatic

Incubates for 6 to 15 days

Profileration and widespread dissemination

Kidney and Liver Functions Test

Organ systems are affected

Septic stage:
Febrile lasting for 4 to 7days, chills, head ache, anorexia, abdominal pain

Immune or Toxic stage:

Can be with or without jaundice last for 4 to 30 days, iritis, headache, meningeal manifestations, oliguria and anuria with progressive renal failure, shock, coma, CHF in severe cases.

Convalescence:
Relapse may occur during 4th o 5th week

Blood Culture

CSF and urine culture, Agglutination test

Death

Leptospirosis

Complications:
Pneumonia Optic Neuritis Peripheral neuritis

Predisposing Factors:
Geographical area (topical islands)

Precipitating Factors: Environmental Conditions Soldier Sweaty skin Aedes Aegypti

Bite from mosquito (portal of entry)

Redness and itchiness in the area

Allowing dengue virus to be inoculated towards the circulation (IP: 3-14)

Dengue Test

Virus disseminated rapidly into blood and stimulates WBCs including B Lymphocytes that produces and secretes immunoglobulins and monocytes/ macrophages and neutrophils.

Hematology: WBC Lymphocytes

Hematology: Monocytes Neutrophils

Antibodies attach to the viral antigens and then monocytes/ macrophages will perform phagocytosis through Fc receptor (FcR) with in the cells of macrophages/ monocytes.

Recognition of dengue viral antigen on infected monocytes by cytotoxic T-cells

Entry to the Liver

Entry to the Spleen

Fever, Flushed warm skin, headache, malaise, chills, anorexia and vomiting

Dengue Fever

Complications: Epistaxis, menorrhagia GI bleeding

Virus ultimately targets liver and spleen parenchymal cells

Cellular direct destruction and infection of the Red Bone Marrow, Precursor cells as well as immunological shortened platelets survival causing platelets lyses.

Activation of killikrein kinin system

Abdominal Pain

HepatoSpleenomegaly

Thrombocytopenia

Increase vascular permeability

Tourniquet test (+)

Ultrasound: Minimal Hepatospleenomegaly

Red sclera in both eyes Petechiae

Hematology: Platelet count

Leakage of plasma

Hematocrit

Hemoconcentration

Hypovolemia

Dengue Hemorrhagic Fever

Shock

Rapid weak pulse, narrowing of pulse pressure and hypotension

Bite of uninfected Aegis aegypti (portal of exit)

Complications: Metabolic Acidosis Hyperkalemia Tissue anoxia Myocarditis Hemorrhage into CNS

Dengue Shock Syndrome

Death

Increasing restlessness, apprehension or anxiety, disturbed sensorium, convulsions, spasticity and hyporeflexia

Dengue Encephalopathy