Frame of thinking DSS

1. Ad vitam: dubia ad bonam
Ad functionam: dubia ad bonam
Ad sanationam: dubia ad bonam
Fluid therapy, supportive therapy, Inotropic Drugs (for DSS)
Anamnesis - physical examination - laboratory tests (Haematology) – Serology Dengue
Apoptosis
Aedes aegypti
mosquitoes
DENV
Viral Factors Host Factors
Mononuklear cell:
Replication of the virus in langerhans
cells
Enviromental factor
Spread via circulation
(primary viremia)
Infecting macrophages
of multiple organs
Endotelial Cell Tissue macrophage Bone marrow (replication
in stromal cells)
Liver cell damage
(hepatomegaly)
Apoptosis/necrosis/dis
turbed liver function
Apoptosis
Releases toxic products into
circulation
Coagulation activation
Supresi
hematopoesis
Elevated platelet
consumption
Trombositopenia
Fibrinolytic system
activation
Coagulation disorder
Increase in
inflammatory mediators
(TNF-Alfa, IL)
Cytokine and other
mediator imbalances
Endothelial cell
dysfunction
Bleeding
Fever,
malaise,
anorexia
Plasma
leakage
Shock
RISK FACTOR
PROBLEM
DIAGNOSTIC
THERAPY
PROGNOSIS
Liver: replication in hepatocytes
and kupffer cells