Signs of Chronic Fatigue Syndrome and Is CFS an Infection?

Tiredness is a daily occurrence which we all will experience after a long day of being awake and active. Everybody feels unusually tired at some point or the other. It may be due to physical exertion, too little sleep or not eating sufficient food as regular meals. However, for people with chronic fatigue syndrome (CFS), there is an usually severe tiredness (fatigue) that persists all of the time.

It is difficult to determine how common chronic fatigue syndrome may be as it is believed to be under-reported and possibly misdiagnosed in many instances. However, it should be considered as a possible cause when unexplained fatigue affects young to middle-aged adults for prolonged periods of time. This fatigue is not just a physical ailment but can have extensive mental, emotional and social effects.

Other conditions that may cause fatigue must first be excluded. Various dietary and lifestyle changes that usually help with easing tiredness also have to be instituted. However, if all of these steps have been taken and the fatigue persists, then it could be chronic fatigue syndrome (CFS) especially when some of the other symptoms discussed below are also present.

Is chronic fatigue syndrome an infection?

Chronic fatigue syndrome is not an infectious condition. In fact the exact cause of CFS is unknown. It was thought that chronic fatigue syndrome may be a viral infection caused by the Epstein-Barr virus (EBV) which is responsible for infection mononucleosis (mono).

Read more on infectious mononucleosis.

However, it is now believed that chronic fatigue syndrome is more likely to be a complication following a viral infection. Other theories have also been postulated as a cause of CFS, including immune system disturbances and even nutritional deficiencies. Chronic fatigue syndrome could triggered be a combination of all of these factors.

How To Spot Chronic Fatigue Syndrome

Chronic fatigue syndrome hould be diagnosed by a medical professional after other possible causes of similar signs and symptoms have been excluded. None of the signs and symptoms of CFS are specific for the condition. This means that there are many other conditions that can present with the same signs and symptoms. It is important to note that there are episodes of flareups and periods of no symptoms. Physical, mental and even emotional strain can be triggers for these episodes, during which the symptoms persist for 24 hours or longer.


Fatigue is understandably the main sign of chronic fatigue syndrome. It is a feeling of extreme tiredness and exhaustion at times despite proper nutrition, an active lifestyle, sufficient sleep and lack of other diseases or disorders where fatigue is a prominent symptom.

The fatigue may vary in intensity, onset and duration from one individual to another. Even minor physical activity like normal daily tasks results in excessive tiredness. This fatigue does not resolve with a few minutes or hours of rest – it tends to persist for more than 24 hours.

Unrefreshed Sleep

Sleep is a period of rest and recuperation that helps to restore physical energy and mental vigor. However, the tiredness that is characteristic of chronic fatigue syndrome persists even after a sufficient duration of sleep. Most people will report this sleep as being unrefreshing, despite the duration and apparent quality of sleep. Even short power naps are of little to no benefit in chronic fatigue syndrome.  Some patients with CFS report disturbed sleep on occasion.

Poor Memory and Concentration

Another common sign of chronic fatigue syndrome, along with the excessive tiredness, is memory problems. It is usually the short-term memory that is affected and not the long-term memory. There may also be difficulty concentrating on tasks and difficulty finding words when talking (verbal dyslexia). Apart from the impact on daily personal tasks, it can also affect a person’s occupation. It can also lead to frustration and contribute to depression.

Joint and Muscle Pain

Varying degrees of joint and muscle pain are also commonly reported in chronic fatigue syndrome. These aches and pains do not correlated with increased physical activity of strain. Often these aches and pain are mistaken for fibromyalgia.

However, there is no correlation between fibromyalgia and chronic fatigue syndrome. In fact the localized sensitivity (trigger points) that is seen with fibromyalgia does not occur in chronic fatigue syndrome. Both fibromyalgia and CFS can co-exist but this is rare.

Enlarged Lymph Nodes

Another feature of chronic fatigue syndrome is enlarged lymph nodes, particularly in the neck, axillary (armpit) and inguinal (near the groin) regions. The nodes are larger than normal but still small, moveable and painless. Enlarged lymph nodes are not specific to chronic fatigue syndrome.

Lymphadenopathy (enlarged lymph nodes) can occur with several different conditions that are unrelated to chronic fatigue syndrome. However, when these other conditions causing lymphadenopathy have been excluded and there is excessive unexplained fatigue, then chronic fatigue syndrome should be considered as a possible cause.

Sore and Discolored Throat

A sore throat is a common complaint in CFS and may be accompanied by a dark red to purple discoloration may be seen at the back of the mouth and throat. This is known as crimson crescents. It is specifically the anterior tonsillar pillars that are discolored, which are the mucous membrane that lies just in front of the tonsils.

These structures may become red in color when inflamed as part of a sore throat (pharyngitis) or inflamed tonsils (tonsillitis). However, the reason why this discoloration occurs in chronic fatigue syndrome is unknown. It a common sign in CFS can also occur in other conditions apart from tonsillopharyngitis and CFS.

Other Signs and Symptoms

A host of other signs and symptoms may be seen with chronic fatigue syndrome. All of these symptoms are non-specific for chronic fatigue syndrome. Therefore it should be considered along with the excessive fatigue, unrefreshed sleep, joint and muscle pain, enlarged lymph nodes and reddish mouth discoloration in order for it to be correlated with chronic fatigue syndrome.

Read more on chronic fatigue syndrome symptoms.

The other signs and symptoms include:

  • Headaches
  • Depression
  • Sensitivity to noise and light
  • Muscle weakness and poor coordination
  • Lightheadedness
  • Nausea
  • Appetite and weight changes

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