Endresen, Gerhard K M · Rheumatology international · 2003 · DOI
This review looked at whether a type of bacteria called mycoplasma might be found in the blood of people with ME/CFS and fibromyalgia. Researchers found mycoplasma in about half of patients with these conditions, compared to only 10% of healthy people. Some patients who received long-term antibiotic treatment appeared to recover completely, suggesting mycoplasma infection might be treatable in certain cases.
This research addresses a longstanding challenge in ME/CFS: the lack of consistent biomarkers. If mycoplasma infection accounts for a significant subset of cases, it could enable better patient subclassification and targeted treatment, potentially explaining why some patients respond to antibiotics while others do not.
This review does not establish causality—mycoplasma detection does not prove the bacteria caused ME/CFS or fibromyalgia. The study cannot determine whether mycoplasma is a primary pathogen, a secondary infection due to immune dysfunction, or simply a bystander. The findings also require replication across diverse patient populations before broad clinical application.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Endresen, Gerhard K M (2003). Mycoplasma blood infection in chronic fatigue and fibromyalgia syndromes.. Rheumatology international. https://doi.org/10.1007/s00296-003-0355-7
BibTeX
@article{mecfsatlas-endresen-2003-mycoplasma-blood,
author = {Endresen, Gerhard K M},
title = {Mycoplasma blood infection in chronic fatigue and fibromyalgia syndromes.},
journal = {Rheumatology international},
year = {2003},
doi = {10.1007/s00296-003-0355-7},
note = {PubMed: 12879275},
url = {https://www.mecfsatlas.com/evidence/endresen-2003-mycoplasma-blood},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/endresen-2003-mycoplasma-blood
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