Characterising DSCATT: A case series of Australian patients with debilitating symptom complexes attributed to ticks

2021 ◽  
pp. 000486742110437
Author(s):  
Jesse Schnall ◽  
Georgina Oliver ◽  
Sabine Braat ◽  
Richard Macdonell ◽  
Katherine B Gibney ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Lyme Disease ◽  
Case Series ◽  
Disease Process ◽  
Chronic Fatigue ◽  
Retrospective Case ◽  
Medical Diagnoses ◽  
Fatigue Syndrome ◽  
First Case ◽  
Medically Unexplained

Objectives(s): To characterise the clinical profile, aetiology and treatment responsiveness of ‘Australian Lyme’, or Debilitating Symptom Complexes Attributed to Ticks. Methods: Single-centre retrospective case analysis of patients referred to the Infectious Diseases Unit at Austin Health – a tertiary health service in Heidelberg, Australia – between 2014 and 2020 for investigation and treatment of suspected Debilitating Symptom Complexes Attributed to Ticks. Patients were included if they had debilitating symptoms suggested by either themselves or the referring clinician as being attributed to ticks. Results: Twenty-nine Debilitating Symptom Complexes Attributed to Ticks cases were included in the analysis. Other than Lyme disease (83%), the most common prior medical diagnoses were Epstein–Barr virus (38%), chronic fatigue syndrome (28%) and fibromyalgia (24%). Prior histories of anxiety (48%) and depression (41%) were common. The most frequently reported symptoms included fatigue (83%), headache (72%) and arthralgia (69%). National Association of Testing Authorities/Royal College of Pathologists of Australasia–accredited serology was not diagnostic of acute infective causes, including Lyme disease, in any patient. Of 25 cases with available data, 23 (92%) had previously been prescribed antimicrobials, with 53% reporting benefit from them. The most common diagnoses made by our hospital were chronic fatigue syndrome (31%), migraines (28%) and fibromyalgia (21%). Only one patient’s symptoms were not accounted for by other diagnoses. Conclusion: This is the first case series of patients with Debilitating Symptom Complexes Attributed to Ticks. They had high rates of other medically unexplained syndromes, and no evidence of acute Lyme disease, or any common organic disease process. Debilitating Symptom Complexes Attributed to Ticks remains medically unexplained, and may therefore be due to an as yet unidentified cause, or may be considered a medically unexplained syndrome similar to conditions such as chronic fatigue syndrome.

scholarly journals Heterodox and Orthodox Discourses in the Case of Lyme Disease: A Synthesis of Arguments

2019 ◽  
Vol 29 (11) ◽  
pp. 1661-1673
Author(s):  
Kate Hinds ◽  
Katy Sutcliffe
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Lyme Disease ◽  
Critical Discourse Analysis ◽  
Chronic Fatigue ◽  
Critical Discourse ◽  
Fatigue Syndrome ◽  
Chronic Lyme Disease ◽  
Medically Unexplained ◽  
Patient Groups ◽  
Insight Into

In this article, we examine the arguments made by authors of published academic articles concerning the debates surrounding chronic Lyme disease (CLD). CLD is an example of a contested condition and shares problems of legitimacy with other medically unexplained conditions such as chronic fatigue syndrome. We use a critical discourse analysis (CDA) approach to understand the arguments of the authors to establish the legitimacy, or not, of a CLD diagnosis. This enabled us to make sense of the nature of the stalemate between patient groups and advocates of the medical establishment, as performed by authors of academic articles. In this article, we bring together the arguments to explain the polemical debate and to support accounts that avoid the impasse to give us greater insight into the experience of chronic illness.

scholarly journals Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: The Human Herpesviruses Are Back!

Biomolecules ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 185
Author(s):  
Maria Eugenia Ariza
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Disease Process ◽  
Chronic Fatigue ◽  
Myalgic Encephalomyelitis ◽  
Barr Virus ◽  
Fatigue Syndrome ◽  
Specific Proteins ◽  
Epstein Barr ◽  
Human Herpesviruses

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) or Systemic Exertion Intolerance Disease (SEID) is a chronic multisystem illness of unconfirmed etiology. There are currently no biomarkers and/or signatures available to assist in the diagnosis of the syndrome and while numerous mechanisms have been hypothesized to explain the pathology of ME/CFS, the triggers and/or drivers remain unknown. Initial studies suggested a potential role of the human herpesviruses especially Epstein-Barr virus (EBV) in the disease process but inconsistent and conflicting data led to the erroneous suggestion that these viruses had no role in the syndrome. New studies using more advanced approaches have now demonstrated that specific proteins encoded by EBV could contribute to the immune and neurological abnormalities exhibited by a subgroup of patients with ME/CFS. Elucidating the role of these herpesvirus proteins in ME/CFS may lead to the identification of specific biomarkers and the development of novel therapeutics.

scholarly journals Alternative Diagnoses to Chronic Fatigue Syndrome in Referrals to a Specialist Service: Service Evaluation Survey

2012 ◽  
Vol 3 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Anoop Devasahayam ◽  
Tara Lawn ◽  
Maurice Murphy ◽  
Peter D White
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Chronic Fatigue ◽  
Service Evaluation ◽  
Depressive Illness ◽  
Primary Diagnosis ◽  
Psychiatric Diagnoses ◽  
Specialist Service ◽  
Medical Diagnoses ◽  
Fatigue Syndrome ◽  
Referral Letters

Objective To assess the accuracy of diagnoses made by referrers to a chronic fatigue syndrome (CFS) service. Design Retrospective service evaluation surveys of both rejected referral letters and medical case-notes after full clinical assessment. Setting A specialist CFS clinic in London, UK. Participants In the first survey, we assessed rejected referral letters between March 2007 and September 2008. In the second survey, we ascertained the primary diagnosis made in case-notes of 250 consecutive new patients assessed between April 2007 and November 2008. Main outcome measures Reasons for rejection of referrals and primary diagnosis in those assessed. Results In the first survey, 154 out of 418 referrals (37%) were rejected. Of these, 77 out of the available 127 referrals (61%) had a likely alternative diagnosis. In the second survey of clinically assessed patients, 107 (43%) had alternative medical/psychiatric diagnoses, while 137 out of 250 (54%) patients received a diagnosis of CFS. The commonest alternative medical diagnoses of those assessed were sleep disorders and the commonest alternative psychiatric diagnosis was depressive illness. Altogether 184 of 377 (49%) patients had alternative diagnoses to CFS. Conclusions Half of all the referred patients to a specialist CFS clinic had alternative medical and psychiatric diagnoses. Specialist medical assessment for patients with unexplained, disabling, chronic fatigue needs to incorporate both medical and psychiatric assessments.

scholarly journals Nationwide Epidemiological Characteristics of Chronic Fatigue Syndrome in South Korea

2021 ◽  
Author(s):  
Eun Jin Lim ◽  
Jin-Seok Lee ◽  
Eun-Jung Lee ◽  
Seok-Ju Jeong ◽  
Ho-Young Park ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
South Korea ◽  
Chronic Fatigue ◽  
Fatigue Syndrome ◽  
Female Predominance ◽  
Increasing Trend ◽  
Medically Unexplained ◽  
Epidemiological Characteristics ◽  
Entire Dataset

Abstract Background: Chronic fatigue syndrome (CFS) is a long-term disabling illness accompanied by medically unexplained fatigue. This study aimed to explore the epidemiological characteristics of CFS in South Korea.Methods: Using the nationwide medical records provided by the Korean Health Insurance Review & Assessment Service (HIRA), we analyzed the entire dataset for CFS patients diagnosed by physicians in Korea from January 2010 to December 2020. Results: The annual mean incidence of CFS was estimated to be 44.71 ± 6.10 cases per 100,000 individuals [95% CI: 40.57, 48.76], and the prevalence rate was 57.70 ± 12.20 cases per 100,000 individuals [95% CI: 49.40, 65.79]. These two rates increased by 1.53- and 1.94-fold from 2010 to 2020, respectively, and showed an increasing trend with aging and an approximately 1.5-fold female predominance. Conclusions: This study is the first to report the nationwide epidemiological features of CFS, which reflects the clinical reality of CFS diagnosis and care in South Korea. This study will be a valuable reference for studies of CFS in the future.

scholarly journals High-frequency rTMS for the Treatment of Chronic Fatigue Syndrome: A Case Series

2016 ◽  
Vol 55 (23) ◽  
pp. 3515-3519 ◽  
Author(s):  
Wataru Kakuda ◽  
Ryo Momosaki ◽  
Naoki Yamada ◽  
Masahiro Abo
Keyword(s):  
Chronic Fatigue Syndrome ◽  
High Frequency ◽  
Case Series ◽  
Chronic Fatigue ◽  
Fatigue Syndrome
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