File:Model of VARV pathogenesis.png

English: "Viremic blood is filtered through the spleen and liver following inoculation. Within 24 hours marginal zone macrophages and Kupffer cells begin expressing viral antigen indicating likely uptake and processing of the pathogen. When the immune response is effective these antigen presenting cells then traffic via the lymphatics to the lymph nodes where a hyperplastic response develops. Concurrently, trafficking to other preferred sites such as skin occurs, and lesions progress and regress as the ongoing adaptive immune response controls and clears the pathogen. In the face of an ineffective immune response, trafficking via macrophages also occurs, however, lymphoid necrosis rather than hyperplasia occurs, allowing unabated trafficking of the virus to other tissues. Infected cells undergo necrosis, pyroptosis, and/or apoptosis which, given the widespread state of infection, results in inflammation, hemorrhage and death. doi:10.1371/journal.pone.0024832.g007"