TNF and Hypoglycemia: Therefore, it could be concluded at this point that cytoadherence to receptors expressed on endothelial cells resulting the focal accumulation of parasitesat high densities leading to microvascular obstruction would restrict the exchange of glucose and oxygen at the capillary level which together with hypoglycaemia, lactic acidosis, high grade of fever and high TNF level might lead to representing the mechanism of disease [58].