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Chronic Fatigue Syndrome Diagnosis

See Also
1. Chronic Fatigue Syndrome
2. Fatigue Causes
General
1. Diagnostic criteria based on CDC 1994 guidelines
Diagnostic Major Criteria (both criteria required, CDC)
1. Persistent or relapsing Fatigue for 6 months
  1. Does not resolve with bed rest
  2. Significant reduction in average daily activity
2. Other chronic conditions excluded
  1. See Fatigue Causes
Diagnostic Minor Criteria (4 present for 6 months, CDC)
1. Sore Throat
2. Painful cervical or axillary lymph nodes
3. Forgetfulness or memory Impairment
4. Myalgias or muscle discomfort
5. Migratory, non-inflammatory arthralgia
  1. No joint swelling or redness
6. New, Generalized Headaches
7. Sleep disturbance (not refreshing)
8. Generalized Fatigue after Exercise over 24 hours
Footnote: Modification of Criteria
1. Earlier CDC 1988 guidelines required 6 minor criteria
  1. Included those listed above
  2. Other criteria present in prior guidelines
    1. Initial symptom onset acute or subacute
    2. Mild fever (37.5 - 38.6 Celsius) or chills
    3. Generalized Muscle Weakness
    4. Neuropsychiatric Symptoms
      1. Photophobia
      2. Transient visual scotomata
      3. Excessive irritability
      4. Confusion
      5. Difficult thinking
      6. Inability to concentrate
      7. Major Depression
2. Earlier CDC 1988 guidelines required sign documentation
  1. Prior guidelines (not required by CDC)
    1. Two or more signs must be documented
    2. Physician must document each sign twice
    3. Signs must be present for longer than 1 month
  2. Criteria
    1. Low grade fever (37.6 - 38.6)
    2. Non-exudative Pharyngitis
    3. Palpable or tender lymph nodes (size <2 cm)
      1. Anterior or posterior cervical Lymphadenopathy
      2. Axillary Lymphadenopathy
References
1. Holms (1988) Ann Intern Med 108:387
2. Levine (1997) Am J Med 105:35

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.