Immature virus particles are transported to the Golgi apparatus, the part of the cell where some of the proteins receive necessary sugar chains (glycoproteins). The now mature new viruses are released by exocytosis. They are then able to enter other white blood cells, such as monocytes and macrophages.The initial reaction of infected cells is to produce interferon, a cytokine that raises many defenses against viral infection through the innate immune system by augmenting the production of a large group of proteins mediated by the JAK-STAT pathway. Some serotypes of the dengue virus appear to have mechanisms to slow down this process. Interferon also activates the adaptive immune system, which leads to the generation of antibodies against the virus as well as T cells that directly attack any cell infected with the virus. Various antibodies are generated; some bind closely to the viral proteins and target them for phagocytosis (ingestion by specialized cells and destruction), but some bind the virus less well and appear instead to deliver the virus into a part of the phagocytes where it is not destroyed but can replicate further. Severe disease
It is not entirely clear why secondary infection with a different strain of dengue virus places people at risk of dengue hemorrhagic fever and dengue shock syndrome. The most widely accepted hypothesis is that of antibody-dependent enhancement (ADE). The exact mechanism behind ADE is unclear. It may be caused by poor binding of non-neutralizing antibodies and delivery into the wrong compartment of white blood cells that have ingested the virus for destruction.
A galactocele (also called lacteal cyst or milk cyst) is a retention cyst containing milk or a milky substance that is usually located in the mammary glands. They can occur in women during or shortly after lactation. They present as a firm mass, often subareolar, and are caused by the obstruction of a lactiferous duct. Clinically, they appear similar to a cyst on examination. The duct becomes more distended over time by epithelial cells and milk. It may rarely be complicated by a secondary infection and result in abscess formation. These cysts may rupture leading to formation of inflammatory reaction and may mimic malignancy. Once lactation has ended the cyst should resolve on its own without intervention. A galactocele is not normally infected as the milk within is sterile and has no outlet through which to become contaminated. Treatment is by aspiration of the contents or by excision of the cyst. Antibiotics are given to prevent infection.Galactoceles may be associated with oral contraceptive use. They have been known to present, although rarely, after Breast augmentation and Breast reduction. References
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Case description and discussion at Harvard.edu