@entity779 viruses cause mild disease in the majority of infected individuals. In most cases, the disease is characterised by fever, @entity10 , @entity3856 , @entity121 , joint @entity158 , @entity391 and @entity294 . In a low percentage of @entity1 , @entity548 and loss of plasma ( @entity548 and plasma leakage) may occur. The @entity2915 results in plasma leakage and, if the compensatory mechanisms of the body fail to control the plasma leakage or if medical intervention is late, shock may set in. Profound shock will subsequently lead to acidic blood ( @entity520 ) and development of @entity5642 ( @entity5642 ). During @entity5642 multiple micro @entity715 occur, leading to organ failure. The mechanisms governing pathogenesis of these forms of severe disease are not clear. High amounts of virus in the blood are believed to cause @entity2100 which, together with infection of endothelial cells and high levels of cytokines and other soluble mediators, may result in @entity548 . In the absence of a correlation between the amount of virus in the blood and disease severity, it is likely that response to infection is an important cause of disease. The aberrant immune response to infection is believed to result in a cytokine storm, defined as an imbalance between cytokines driving an @entity32 (pro-inflammatory) and those silencing an @entity32 (anti-inflammatory). Several lines of evidence indicate that displacement of viral genotype and host genetic background are key factors driving the production of a cytokine storm. Several cytokines are known to induce apoptosis, a form of cell suicide (cause of @entity548 ), and/or affect adherens junctions (cause permeability) in vitro. Whether these cytokines may have such effects in vivo remains to be established.

XXXX pathogenesis: a disease driven by the host response.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity32 :: ('MESH:D007249', 'Disease') :: ['inflammation'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding', 'haemorrhage'] @entity779 :: ('MESH:D003715', 'Disease') :: ['Dengue'] @entity391 :: ('MESH:D014839', 'Disease') :: ['vomiting'] @entity294 :: ('MESH:D003967', 'Disease') :: ['diarrhoea'] @entity10 :: ('MESH:D006261', 'Disease') :: ['headache'] @entity520 :: ('MESH:D000138', 'Disease') :: ['metabolic acidosis'] @entity2915 :: ('MESH:D006948', 'Disease') :: ['hyper-permeability syndrome'] @entity5642 :: ('MESH:D004211', 'Disease') :: ['DIC', 'disseminated intravascular coagulation'] @entity2100 :: ('MESH:D005600', 'Disease') :: ['vascular fragility'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pains'] @entity715 :: ('MESH:D013927', 'Disease') :: ['thromboses'] @entity3856 :: ('MESH:D058447', 'Disease') :: ['pain behind the eyes'] @entity121 :: ('MESH:D009135', 'Disease') :: ['muscle ache']
@entity779 :: (MESH:D003715,Disease) :: ['Dengue']
