Fast Five Quiz: How Much Do You Know About Chronic Fatigue Syndrome?

Michael Stuart Bronze, MD


December 04, 2015

CFS should be diagnosed only after other causes of fatigue are excluded and the fatigue has lasted for at least 6 months. An absence of cognitive difficulties should exclude a diagnosis of CFS. Signs of adrenal or thyroid disorders should also exclude a diagnosis of CFS, in that the fatigue is explained by endocrinologic factors. Similarly, HIV infection and AIDS may also cause chronic fatigue.

In most patients, the physical examination is unrevealing. However, many patients have small, moveable, painless lymph nodes that most commonly involve the neck, axillary region, or inguinal region. A single lymph node that is very large, tender, or immobile suggests a diagnosis other than CFS. Similarly, generalized adenopathy suggests a diagnosis other than CFS.

An isolated report from a single center suggested that a purple or crimson discoloration of both anterior tonsillar pillars (crimson crescents) in the absence of pharyngitis is might be a marker in patients with CFS. The cause of crimson crescents is unknown, but they are common in patients with CFS. However, crimson crescents are not specific for CFS, and additional studies are needed to determine the true frequency of this finding in patients with CFS.

Trigger points, which suggest fibromyalgia, are absent in patients with CFS. CFS and fibromyalgia rarely coexist in the same patient.

For more on the physical examination of CFS, read here.