To the Editor: The cause of extreme pyrexia — that is, body temperature in excess of 41.1°C — is varied and includes infection, heat stroke, hypothalamic dysfunction and hypermetabolic states. Most patients with hyperpyrexia, regardless of its origin, respond to conventional therapy of aspirin or acetaminophen, surface cooling and intravenous fluid replacement; in Simon's review, 50 per cent of patients responded to these measures.* It is a rare patient who requires more aggressive management, such as iced gastric lavage, iced intravenous fluids or parenteral chlorpromazine. In the patient with extreme pyrexia unresponsive to conventional treatment described below, sodium nitroprusside proved. . .
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