PREDISPOSING FACTORS usually affects children younger than 15 years affect both sexes

PATHOPHYSIOLOGY Dengue Hemorrhagic Fever

Etiology: Second infection with 1 of the 4 serotypes of dengue virus through the bite of Female Aedes mosquito

D E N G U E F E V E R
D E N G U E
D H E E N M G O U R E R H S A H G O IC K C S Y F N E D V R E O R
maculopapular rash

PRECIPITATING FACTORS Living in endemic areas of the tropics (or warm, moist climates) explosive population growth unplanned urban overpopulation with inadequate public health systems poor standing

Infection of target cells, primarily those of the reticuloendothelial system, such as dendritic cells, hepatocytes, and endothelial cells Fever of 41C (lasts approximately 27days) headach e body pain destructive actions of the virus on bone marrow precursor cells nausea and vomiting

production of immune mediators Activation of cellular and humoral immune response

active viral replication and cellular destruction bone pain

thrombocytope nia capillary fragility petechiae

lymphopenia

Leukopenia

gingival bleeding

positive tourniquet test

gastrointesti nal bleeding

progressive thrombocytopenia release of histamine increased capillary permeability

deranged coagulation parameters (prothrombin time, partial thromboplastin time) Liver damage

Capillary congestion

plasma leakage

progressive effusions (pleural or peritoneal)

ascites

hemoconcentration

low albumin

increasing hematocrit (20% absolute rise from baseline)

Decreased circulating blood volume

M E

circulatory failure

hypothermia

hypotension

narrow pulse pressure (< 20 mm Hg) vomiting

restlessnes s

shock

death