Extreme pyrexia.

Twenty-eight cases of extreme pyrexia seen in a five-year period were analyzed retrospectively. All of the patients had temperatures between 41.1 C (106 F) and 42.2 C (108 F) with a mean maximum temperature of 41.4 C (106.6 F). Infection, thermoregulatory defects, or a combination thereof accounted for fever in these patients. There was little evidence of direct tissue damage caused by fever, and standard therapy with aspirin or acetaminophen, vigorous surface cooling, and volume expansion was generally sucessful. Mortality could be related to the extreme pyrexia in only 7% (2) but an additional 21% (6) of these patients later died from serious underlying diseases.