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Question: Hi,
I've been suffering from CFS for a year and a half now. I have read several academic papers on the possible association between some cases of CFS and an on-going subacute infection/inflammation that is caused by bacteria, virus or a parasite. Nothing is proven but my GP has agreed to do a comprehensive test for some selected bacteria, etc.. just in case something was found and could be treated. She doesn't know, however, which tests to do.
I have selected the following tests based on my study of academic literature:
toxoplasmosis
candidiosis
chlamydia pneumoniae
mycoplasma (pneumonia, fermentans)
Epstein-Barr virus
1) I was wondering whether you think that Herpes viruses should also be included given that I did not have the typical symptoms of being infected with one. My CFS started with broncho-pneumonia, I had no fever, only a persistent dry cough for about two months, after which I exhibited neurological symptoms such as cognitive deficits, muscle spasms and pain, and fatigue.
2) If you can think of any other fungi, viruses, bacteria or parasites, that you think should be included, then please let me know.
Thank you!
All the best,
XXXX
I've been suffering from CFS for a year and a half now. I have read several academic papers on the possible association between some cases of CFS and an on-going subacute infection/inflammation that is caused by bacteria, virus or a parasite. Nothing is proven but my GP has agreed to do a comprehensive test for some selected bacteria, etc.. just in case something was found and could be treated. She doesn't know, however, which tests to do.
I have selected the following tests based on my study of academic literature:
toxoplasmosis
candidiosis
chlamydia pneumoniae
mycoplasma (pneumonia, fermentans)
Epstein-Barr virus
1) I was wondering whether you think that Herpes viruses should also be included given that I did not have the typical symptoms of being infected with one. My CFS started with broncho-pneumonia, I had no fever, only a persistent dry cough for about two months, after which I exhibited neurological symptoms such as cognitive deficits, muscle spasms and pain, and fatigue.
2) If you can think of any other fungi, viruses, bacteria or parasites, that you think should be included, then please let me know.
Thank you!
All the best,
XXXX
Brief Answer:
Several infections are possibly related to CFS.
Detailed Answer:
Hello XXXXXXX
I have read your query and understand your concerns.
As you read by yourself, there are several infections related to, or are accused to serve as a trigger of chronic fatigue syndrome:
1. Bacteria ( Mycoplasma species, Borrelia burgdorferi, Clamydia pneumoniae)
2. Viruses ( Epstein-Barr or HHV4, Cytomegalovirus, Parvoviruses, Human herpesvirus 6 or HHV6)
3. Parasites ( Toxoplasmosis, Giardiasis, Amebiasis)
4. Funghi or yeast ( Candidiasis)
Since your CFS started with pulmonary problems, microorganisms that affect pulmonary system should be assessed first.
These include Mycoplasma species, Clamydia, Cytomegalovirus ( if imunocompromissed ), HHV6.
If no positive results after these first possible infection or in doubt clinically about other infections, full battery tests should be carried out.
In some patients are reported multiple and combined infections too.
Hope this helps. If you have further questions or clarifications, feel free to ask.
Wishing you good health.
Several infections are possibly related to CFS.
Detailed Answer:
Hello XXXXXXX
I have read your query and understand your concerns.
As you read by yourself, there are several infections related to, or are accused to serve as a trigger of chronic fatigue syndrome:
1. Bacteria ( Mycoplasma species, Borrelia burgdorferi, Clamydia pneumoniae)
2. Viruses ( Epstein-Barr or HHV4, Cytomegalovirus, Parvoviruses, Human herpesvirus 6 or HHV6)
3. Parasites ( Toxoplasmosis, Giardiasis, Amebiasis)
4. Funghi or yeast ( Candidiasis)
Since your CFS started with pulmonary problems, microorganisms that affect pulmonary system should be assessed first.
These include Mycoplasma species, Clamydia, Cytomegalovirus ( if imunocompromissed ), HHV6.
If no positive results after these first possible infection or in doubt clinically about other infections, full battery tests should be carried out.
In some patients are reported multiple and combined infections too.
Hope this helps. If you have further questions or clarifications, feel free to ask.
Wishing you good health.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thanks for your answer.
1) By full battery tests, you mean the ones you named in 1,2,3,4 right?
2) I had a spinal tap in February and they found several things:
elevated: Anti- CMV IgG CSF 1, Anti-CVM IgG CSF WB 1, Anti VZV IgG CSF 1, AI VZV IgG 2.
corresponding in serum and elevated: Anti-CMV IgG1, Anti-CMV IgG WB 1, Anti VZV IgG 1
I had chickenpox as a kid so I guess the antibodies are the effect of that disease.... Otherwise I guess the antibodies against citomegalovirus don't mean anything?
3) beside the things above, these were the results of the spinal tap... would you mind having a look?
elevated CB, monocytic oligocytosis with lipophagic reaction, slight excess of lymphocytes, proteinocytological dissociation, elevated permeability of BB barrier, elevated transferin, orosomukoid, low C4, elevated Apo A.
systemic inflammatory response, no sign of neuro-infection, signs of secondarily induced inflammatory response, no sign of multiple sclerosis.
Given these (for you new) findings, does it change anything about your recommendations? Thank you.
1) By full battery tests, you mean the ones you named in 1,2,3,4 right?
2) I had a spinal tap in February and they found several things:
elevated: Anti- CMV IgG CSF 1, Anti-CVM IgG CSF WB 1, Anti VZV IgG CSF 1, AI VZV IgG 2.
corresponding in serum and elevated: Anti-CMV IgG1, Anti-CMV IgG WB 1, Anti VZV IgG 1
I had chickenpox as a kid so I guess the antibodies are the effect of that disease.... Otherwise I guess the antibodies against citomegalovirus don't mean anything?
3) beside the things above, these were the results of the spinal tap... would you mind having a look?
elevated CB, monocytic oligocytosis with lipophagic reaction, slight excess of lymphocytes, proteinocytological dissociation, elevated permeability of BB barrier, elevated transferin, orosomukoid, low C4, elevated Apo A.
systemic inflammatory response, no sign of neuro-infection, signs of secondarily induced inflammatory response, no sign of multiple sclerosis.
Given these (for you new) findings, does it change anything about your recommendations? Thank you.
Brief Answer:
All lab tests should be done.
Detailed Answer:
Welcome back XXXXXXX and thanks for the new information.
Antibodies against CMV in cerebrospinal fluid ( CSF) are not normally found, this test should result negative.
Presence of antibodies in CSF means there was infection that involved nervous system too.
Only antibodies against VZV (varicella) are related to chicken pox, not antibodies against CMV.
About the other CSF tap laboratory findings, they support nervous system involvement in the past.
As I said previously, many patients with chronic fatigue syndrome may be affected by multiple infections, instead of one, so full battery I mean full lab screening about previously mentioned infections.
Regarding to all this, what is the status of your immune system?
My recommendations remain the same, in addition, an assessment of immune system status ( inherited or acquired immunodeficiency), is important.
Hope I helped you. Best regards.
All lab tests should be done.
Detailed Answer:
Welcome back XXXXXXX and thanks for the new information.
Antibodies against CMV in cerebrospinal fluid ( CSF) are not normally found, this test should result negative.
Presence of antibodies in CSF means there was infection that involved nervous system too.
Only antibodies against VZV (varicella) are related to chicken pox, not antibodies against CMV.
About the other CSF tap laboratory findings, they support nervous system involvement in the past.
As I said previously, many patients with chronic fatigue syndrome may be affected by multiple infections, instead of one, so full battery I mean full lab screening about previously mentioned infections.
Regarding to all this, what is the status of your immune system?
My recommendations remain the same, in addition, an assessment of immune system status ( inherited or acquired immunodeficiency), is important.
Hope I helped you. Best regards.
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you, your answers are extremely helpful and informative.
I have had a basic immunological work-up done. This included IgA, IgM, IgG, IgE, CRP, C3, C4, leucocytes, erytrocytes, hemoglobin, hematocrit, MCV, MCHC, trombocytes, RDW, neutrophil. segments, lymphocytes, monocytes, eosinophiles, basiphiles, fT4, anti TG, anti TPO. anti-dsDNA elisa, Anti-ENA screen, ASLO, anti citrulin, ECP.
All came within range, except IgE, which is elevated at 280 range {0 - 100 IU/ml}.
With these results available, is there a need for some other immunological tests or is this complete? Thanks.
I have had a basic immunological work-up done. This included IgA, IgM, IgG, IgE, CRP, C3, C4, leucocytes, erytrocytes, hemoglobin, hematocrit, MCV, MCHC, trombocytes, RDW, neutrophil. segments, lymphocytes, monocytes, eosinophiles, basiphiles, fT4, anti TG, anti TPO. anti-dsDNA elisa, Anti-ENA screen, ASLO, anti citrulin, ECP.
All came within range, except IgE, which is elevated at 280 range {0 - 100 IU/ml}.
With these results available, is there a need for some other immunological tests or is this complete? Thanks.
Brief Answer:
Elevated IgE related to parasitic infection.
Detailed Answer:
Welcome back XXXXXXX
Those tests show your immune system is okay.
Elevated IgE indicates a probable underlying parasitic infection, so, in my opinion, there is still need for full battery testing about infections related to chronic fatigue syndrome.
Hope this helps.
Best regards.
Elevated IgE related to parasitic infection.
Detailed Answer:
Welcome back XXXXXXX
Those tests show your immune system is okay.
Elevated IgE indicates a probable underlying parasitic infection, so, in my opinion, there is still need for full battery testing about infections related to chronic fatigue syndrome.
Hope this helps.
Best regards.
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Above answer was peer-reviewed by :
Dr. Raju A.T
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