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Low intake of fluids, loss of fluids because of vomiting and pyrexial sweating, cytokine and NO mediated arterial vasodilatation specifically organ specific release of NO, resistance to vasoactive hormones, cytopathic hypoxia leading to decreased ATP synthesis, cytoadherence of PRBCs, etc all may contribute singly or in combination towards malarial ARF.
Eighty-nine per cent of respondents warned their patients about the 5-6-day 'dip', when patients typically called their surgeon and reported that pain had increased, and that they couldn't eat, had become pyrexial and wished to visit the surgeon.
Clinically he was pyrexial, with worsening otitis externa and a recurring polypoid mass formation with large, pale granulations.
One of these patients had become confused and pyrexial 24 hours postoperatively, and a perforation of her esophagus was assumed.