23

XI. PATHOPHYSIOLOGY

Medical Diagnosis

T/C Dengue Hemorrhagic Fever/ Pleural Effusion, T/C Liver Pathology

Definition

Dengue Hemorrhagic Fever - is a severe, potentially deadly infection spread by certain species of mosquitoes (Aedes
aegypti).

Pleural Effusion - is excess fluid that accumulates in the pleural cavity, the fluid-filled space that surrounds the lungs.
Excessive amounts of such fluid can impair breathing by limiting the expansion of the lungs during inhalation.

Liver Pathology – a condition characterized by any liver diseases or condition

Schematic Diagram Precipitating

Environmental conditions (open spaces with water
Predisposing pots, and plants)
Geographical area – tropical islands in the Immunocompromise
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 Redness & itchiness in

the Skin) the area

Allowing dengue virus to be inoculated

towards the circulation/blood (Incubation
Period: 3-14 days)
 24
Virus disseminated rapidly into the blood Diagnostic:
and stimulates WBCs including B Hematology :
lymphocytes that produces and secretes Increased WBC:
immunoglobulins (antibodies), and 12,900/cumm
monocytes/macrophges, neutrophils (5,000- 10,000/cumm)
Diagnostic: Increased
Hematology : Lymphocytes: 49% (20-
Decreased Antibodies attach to the viral 40%)
Monocytes: antigens, and then
4%(8-14%) monocytes/macrophages will
Decreased perform phagocytosis through Fc
Neutrophils: receptor (FcR) within the cells and
49%(50-70%) Entry to the Entry to the
dengue virus replicates in the cells
spleen, and bone marrow
liver
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
flushed; headache of
3/10 pain scale; whitish Fever
spots; body weakness
 25

Virus ultimately targets liver Cellular direct destruction and

and spleen parenchymal cells infection of red bone marrow
Diagnostic:
Ultrasound: where infection produces precursor cells as well as Diagnostic:
minimal apoptosis/cell death immunological shortened platelet Hematology :
hepatospleno survival causing platelet lyses Decreased
megaly Platelet:
Blood Chemistry: Hepatosplenomeg 68,000/cumm
Thrombocytop
SGOT: 558.0 aly
U/L(Up to 46) enia Signs/
symptoms:
Signs/ symptoms: Dengue Hemorrhagic Red sclera in
>Abdominal pain
with 5/10 pain
Fever both eyes
Petechiae
scale as
verbalized. Increase number and size of
Signs/
the pores in the capillaries
symptoms:
which leads to a leakage of +1 Bipedal
fluid from the blood to the edema; weak
interstitial fluid (capillary bounding pulse
Signs/ symptoms:
leakage) of the different
Profuse non-productive
cough with white
sputum with blood Signs/ symptoms:
spots noted; shallow & Abdominal distention
rapid respirations of Pleural Ascite with abdominal girth of
35cpm; crackles/rales effusion s 93cm (36.6 inches);
hypoactive bowel
sounds of 2/min
Diagnostic:
Ultrasound: Diagnostic:
Conclusion: Ultrasound:
Minimal bilateral Conclusion:
pleural effusion. Recovery Complications: Moderate
Intense bleeding ascites
Pulmonary Edema
Shock
Very low blood
pressure
Liver cirrhosis
Death
 26

Legend:

- Pathophsiology

- Medications - Signs and symptoms

- Diagnostic exams - Complications

- Interventions - Early signs