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Cléa Melenotte a Michel Drancourt a Jean Pierre Gorvel b Jean Louis Mège a DidierRaoult a
a Aix Marseille University, IRD, MEPHI, IHU, méditerranée infection, AP–HM, 13385 Marseille cedex 05, France
b Aix Marseille University, CNRS, Inserm, CIML, 13288 Marseille cedex 09, France
Received 31 July 2018, Accepted 15 January 2019, Available online 2 February 2019.
https://doi.org/10.1016/j.medmal.2019.01.006
https://www.sciencedirect.com/science/article/pii/S0399077X18307923
Highlights
• Subjective symptoms described in post-infectious chronic fatigue syndromes are still misunderstood and no evidence is available to prove that such symptoms could be related to dormant bacterial infections or to carriage of viable bacteria.
• Conversely, latent infection could be defined as an asymptomatic disease prone to reactivation in which the microorganisms are likely to be dormant.
• The antibiotic therapy has therefore no place in the treatment of chronic fatigue syndrome and latent infection, except in cases of latent syphilis and latent tuberculosis infection to prevent, after the primary infection, progression to the secondary or tertiary stage of the disease.
Abstract
Post-infectious chronic fatigue syndrome is a public health problem. Etiologies and physiopathological mechanisms are unknown. Some viruses are known to be involved in post-infectious chronic fatigue syndrome, but the role of bacterial infection is still questioned, especially in cases of post-treatment Lyme disease syndrome where subjective symptoms are regularly attributed to the presence of the dormant bacterium without scientific evidence. However, the medical experience of recalcitrant infections, relapses, and reactivations questions the role of “dormant bacteria” in asymptomatic latent infections as well as in subjective symptoms.
We summarized scientific literature data on post-bacterial infection chronic fatigue syndrome, the role of dormant bacteria in latent infections, and bacterial asymptomatic carriage. Subjective symptoms described in post-infectious chronic fatigue syndromes are still misunderstood and there is no evidence suggesting that such symptoms could be related to dormant bacterial infection or carriage of viable bacteria. Psychological trauma may be part of these subjective symptoms. Post-infectious chronic fatigue syndrome could nonetheless be due to unknown microorganisms. Antibiotic treatment is not required for latent infections, except for latent syphilis and latent tuberculosis infections to prevent, after the primary infection, progression to the secondary or tertiary stage of the disease.
Keywords
Lyme disease
Latent infection
Post-infectious chronic fatigue syndrome
a Aix Marseille University, IRD, MEPHI, IHU, méditerranée infection, AP–HM, 13385 Marseille cedex 05, France
b Aix Marseille University, CNRS, Inserm, CIML, 13288 Marseille cedex 09, France
Received 31 July 2018, Accepted 15 January 2019, Available online 2 February 2019.
https://doi.org/10.1016/j.medmal.2019.01.006
https://www.sciencedirect.com/science/article/pii/S0399077X18307923
Highlights
• Subjective symptoms described in post-infectious chronic fatigue syndromes are still misunderstood and no evidence is available to prove that such symptoms could be related to dormant bacterial infections or to carriage of viable bacteria.
• Conversely, latent infection could be defined as an asymptomatic disease prone to reactivation in which the microorganisms are likely to be dormant.
• The antibiotic therapy has therefore no place in the treatment of chronic fatigue syndrome and latent infection, except in cases of latent syphilis and latent tuberculosis infection to prevent, after the primary infection, progression to the secondary or tertiary stage of the disease.
Abstract
Post-infectious chronic fatigue syndrome is a public health problem. Etiologies and physiopathological mechanisms are unknown. Some viruses are known to be involved in post-infectious chronic fatigue syndrome, but the role of bacterial infection is still questioned, especially in cases of post-treatment Lyme disease syndrome where subjective symptoms are regularly attributed to the presence of the dormant bacterium without scientific evidence. However, the medical experience of recalcitrant infections, relapses, and reactivations questions the role of “dormant bacteria” in asymptomatic latent infections as well as in subjective symptoms.
We summarized scientific literature data on post-bacterial infection chronic fatigue syndrome, the role of dormant bacteria in latent infections, and bacterial asymptomatic carriage. Subjective symptoms described in post-infectious chronic fatigue syndromes are still misunderstood and there is no evidence suggesting that such symptoms could be related to dormant bacterial infection or carriage of viable bacteria. Psychological trauma may be part of these subjective symptoms. Post-infectious chronic fatigue syndrome could nonetheless be due to unknown microorganisms. Antibiotic treatment is not required for latent infections, except for latent syphilis and latent tuberculosis infections to prevent, after the primary infection, progression to the secondary or tertiary stage of the disease.
Keywords
Lyme disease
Latent infection
Post-infectious chronic fatigue syndrome