|
A Note on Chronic fatigue and Persistent Infection with Chlamydia pneumoniae Chronic Fatigue Syndrome probably has many causes. This may account for the disappointing results of antibiotics in double-blind trials. CFS is characterised by fatigue, mental fogging, rapid exhaustion and depression. It is often accompanied by muscle pains, fasciculation (fine muscle twitching) and pain round the eyes. Some people can develop the feeling that they are permanently on the verge of falling sick with the 'flu. Night-sweats are common, and prolonged sleep leads to no real rest. There is sometimes a diurnal pattern to these symptoms. What causes these profound disturbances? The answer may lie in the body's response to the pathogen; persistent infections may cause a maelstrom in the cytokine system (cytokines are the messenger-molecules which send information between cells.) There is evidence that some cytokines can cause a fever by direct action on the brain; interferons (a family of cytokines) can cause a 'flu-like illness. There is mounting evidence that in chronic intracellular infections the immune system becomes imbalanced, and is not only ineffective in eradicating the organism but also damages the host. This may be the case in similar chronic fatiguing diseases caused by other persistent pathogens, including Mycoplasma sp., Coxiella Burneti (Q fever) and Borrelia garinii and B. burgdorferi. It is quite possible that other, as yet unknown agents may also have a part to play. Chlamydia pneumoniae is but one organism which may cause a chronic unresolved infection which results in a CFS picture. Pointers are an association with prolonged respiratory infections including sinusitis, pharyngitis, tracheitis and pneumonia. Antibiotic treatment, while often quickly removing the mental fogging and fatigue, may intensify the 'flu-like feelings. This may be because the dead bacteria are now exposed to the immune system. And, as bacterial remnants are released from host-cells during cell replacement programmes, these 'flu-like episodes may occur for months and even years after the beginning of treatment. Evidence for this lies in the finding that Chlamydia pneumoniae specific IgA levels remain elevated long after treatment has begun, and while clinical improvements are being made. If these symptoms occur, particularly if accompanied by a sudden unexpected weight-loss, a close search should be made for malignancy. Tumours — particularly lymphomas — are known to provoke a similar blizzard of cytokines. Haematologists often refer to the tetrad of weight-loss, fatigue, night-sweats and intermittent fevers as 'B symptoms'. page uploaded 8th April 2005 updated 27th May 2005
|