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Got watercooling?
Seriously, though. Are you overclocking the system? What speed is it? I found older Athlon and P3 rigs to be sufficient on 1 exhaust fan, 1 intake/1 exhaust was the best setup. Kept the case temp at room temperature or just slightly above.
If you are going for serious overclocking and gaming. Then fill up with a couple intake and exhaust. Be creative and put a blowhole in the top, one side fan blowing in over the video and motherboard (or 2) and then suck air in both the front and rear mounts to create a sort of wind tunnel with air being sucked up to the top-mounted blowhole(s) and the hot air can escape that way.
4 with 1 front, 1 rear, 1 side, 1 blowhole