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Bacterial toxins and other pyrogens stimulate the production of cytokines by leukocytes, and these cytokines increase prostaglandin synthesis in the preoptic area of the hypothalamus

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This is consistent with our hypothesis that this group would include patients in whom excitotoxic damage during acute florid illness has led to subsequent reductions in mental and neural activity mediated by glutamatergic neurotransmission [3, 4]