infectious diseases
Dengue Hemorrhagic Fever Dengue Shock Syndrome
Introduction
Dengue hemorrhagic fever is a variant presentation of dengue infection that occurs primarily in children<10 years living in areas where dengue is endemic. Dengue hemorrhagic fever, which has also been called Philippine, Thai, or Southeast Asian hemorrhagic fever, frequently requires prior infection with the dengue virus. Dengue hemorrhagic fever is an immunopathologic disease; dengue virus–antibody immune complexes trigger release of vasoactive mediators by macrophages. The mediators increase vascular permeability, causing vascular leakage, hemorrhagic manifestations, hemoconcentration, and serous effusions, which can lead to circulatory collapse (ie, dengue shock syndrome). 