Nijs J [1, 3], PT; Nicolson GL , PhD; De Becker P , PhD; De Meirleir K , MD, PhD
1: Department of Human Physiology, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Belgium
2: Institute for Molecular Medicine, Huntington Beach, USA
3 To whom correspondence should be addressed: Vakgroep MFYS, AZ-VUB KRO gebouw, 1, Laarbeeklaan 101, 1090 Brussel, Belgium.
Tel: +32 2 477 4604.
Fax: +32 2 477 4607.
Prevalence as well as clinical importance of Mycoplasma infections in Chronic Fatigue Syndrome and related disorders (Gulf War Illness, Fibromyalgia) has been extensively reported in the scientific literature [1-5]. However, all previous reports highlighted the presence of Mycoplasmae in American CFS patients. Epidemic peaks of, for instance, M pneumoniae infections  preclude extrapolation of these results outside the United States.
Among Belgian CDC-defined Chronic Fatigue Syndrome patients , is Mycoplasma detection using forensic polymerase chain reaction relevant in identifying subsets? To answer this medical care research question, we conducted a prospective study in which we tested the presence of Mycoplasma spp in the blood of 272 CFS-patients. The study was conducted in Brussels, at a university-based outpatient clinic (Vrije Universiteit Brussel).
Between the first of January and the end of June 1999, we enrolled 272 consecutive patients seeking care for prolonged fatigue as major complaint. All included patients fulfilled current international CDC case definition for Chronic Fatigue Syndrome , while more than 70% were defined as CFS patients according to the more stringent Holmes et al 8 criteria. In 85 out of 272 Belgian CFS-patients (31.3%), we could not detect Mycoplasmal species. One hundred and eighty-seven (68.7%) patients were infected by at least one type of Mycoplasma. Among Mycoplasma-infected patients, M hominis is the most frequently observed (N = 99; 36.4% of overall sample), followed by M pneumoniae-infection (N = 71; 26.1%). M penetrans was not observed. Multiple infections were detected in 47 patients (17.3%).
With the absence of M penetrans in mind, all possible combinations were present and equally distributed. Compared to American patients, a slightly different pattern of Mycoplasmae infections was observed.
1. NASRALLA MY, HAIER J, NICOLSON NL, NICOLSON GL. Examination of Mycoplasmas in blood of 565 chronic illness patients by polymerase chain reaction. In J Med Biol Environ 2000; 28(1): 15-23
2. NASRALLA M, HAIER J, NICOLSON GL. Multiple Mycoplasmal infections detected in blood of patients with Chronic Fatigue Syndrome and / or Fibromyalgia. Eur J Clin Microbiol Infect Dis 1999; 18: 859-865
3. NICOLSON GL, NASRALLA MY et al. Role of Mycoplasmal infections in Fatigue Illnesses: Chronic Fatigue and Fibromylagia Syndromes, Gulf War Illness and Rheumatoid Arthritis. Journal of Chronic Fatigue Syndrome 2000; 6(3/4): 23-39
4. NICOLSON GL, NICOLSON NL. Diagnosis and treatment of Mycoplamsmal infections in Persian Gulf War Illness – CFIDS patients. International journal of occupational medicine, immunology and toxicology 1996; 5:67-78
5. VOJDANI A, FRANCO AB. Multiplex PCR for the detection of Mycoplasma fermentans, M hominis, and M penetrans in patients with Chronic Fatigue Syndrome, Fibromyalgia, Rheumatoid Arthritis, and Gulf War Syndrome. Journal of Chronic Fatigue Syndrome 1999; 187-197
6. CLYDE WA. Clinical overview of typical Mycoplasma pneumoniae infections. Clinical Infectious Disease 1993; 17(S1):83-89
7. FUKUDA K, STRAUSS SE et al. The Chronic Fatigue Syndrome, a comprehensive approach to its definition and study. Ann Intern Med 1994; 121: 953-959
8. HOLMES GP, KAPLAN JE et al. Chronic Fatigue Syndrome, a working case definition. Ann Intern Med 1988; 108:387-389
Source: www.ahmf.org. Presented at the 2001 Clinical and Scientific Meeting: Myalgic Encephalopathy/Chronic Fatigue Syndrome: "The Medical Practitioners' Challenge in 2001."