Chronic Fatigue and Postinfective Fatigue Syndromes

Andrew R. Lloyd; Ian Hickie; Denis Wakefield

doi:10.1128/9781555815981.ch17

Chapter 17 : Chronic Fatigue and Postinfective Fatigue Syndromes

Authors: Andrew R. Lloyd, Ian Hickie, Denis Wakefield

Content Type: Reference

Publication Year: 2009

Category: Viruses and Viral Pathogenesis

Book DOI: 10.1128/9781555815981

Chapter DOI: 10.1128/9781555815981.ch17

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Abstract:

Chronic fatigue syndrome and postinfective fatigue syndrome have been the focus of considerable research interest, including epidemiological studies; investigations of microbiological, immunologic, neuroendocrine, metabolic, and psychological hypotheses of etiology; and treatment interventions. The most widely known predecessor to the current label of chronic fatigue syndrome is the disorder termed ‘‘neurasthenia,’’. The fatigue state was present from the time of onset of symptoms of the acute infection and was stable in character over time, suggesting that the genesis of the postinfective fatigue syndrome is intrinsically linked to the host-pathogen interactions in the acute infection phase. The fatigue syndrome was most prevalent in those with mononucleosis documented to be due to Epstein-Barr virus (EBV) infection and was shown to be essentially independent of psychiatric diagnoses. The modern era of research in relation to chronic fatigue syndrome has been marked by the formulation of diagnostic criteria. The Centers for Disease Control and Prevention then proposed the term chronic fatigue syndrome to replace numerous previous eponyms. Studies with patients with the overlapping clinical syndrome of fibromyalgia have demonstrated the benefit of a combination of a low-dose tricyclic antidepressant and a nonsteroidal anti-inflammatory agent, where effects on muscle pain and sleep disturbance are notable, arguing for a similar therapeutic trial in patients with chronic fatigue syndrome in whom pain and sleep disturbance are prominent.

Citation: Lloyd A, Hickie I, Wakefield D. 2009. Chronic Fatigue and Postinfective Fatigue Syndromes, p 371-383. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch17

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Chronic Fatigue and Postinfective Fatigue Syndromes

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FIGURE 1

Time to resolution of symptoms in 50 patients monitored prospectively from the time of diagnosis of serologically documented acute EBV infection. The vertical axis indicates the percentage of the group reporting the symptom (50; A. R. Lloyd, unpublished data).

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FIGURE 1

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FIGURE 2

Approach to the assessment of chronic fatigue. CFS, chronic fatigue syndrome; TSH, thyroid-stimulating hormone. (Adapted from reference 51 with permission.)

10.1128/9781555815981/f0376-01_thmb.gif

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FIGURE 2

Approach to the assessment of chronic fatigue. CFS, chronic fatigue syndrome; TSH, thyroid-stimulating hormone. (Adapted from reference 51 with permission.)

References

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Tables

Chronic Fatigue and Postinfective Fatigue Syndromes

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TABLE 1

Infectious diseases putatively linked to fatigue syndromes a

TABLE 1

Infectious diseases putatively linked to fatigue syndromes a

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TABLE 2

Diagnostic criteria for chronic fatigue syndrome a

TABLE 2

Diagnostic criteria for chronic fatigue syndrome a

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TABLE 3

Causes of chronic fatigue

TABLE 3

Causes of chronic fatigue