Howanietz, Helmuth, Graf, Ulrike, Kainz, Theresa · Padiatrie und Padologie · 2022 · DOI
This case report describes a 17-year-old girl who experienced severe fatigue caused by Epstein-Barr virus (EBV) infection, commonly known as infectious mononucleosis. The authors highlight that fatigue in young people can come from many different causes, not just COVID-19, and that it's important to identify the correct cause. Notably, about 13.5% of people who have EBV infection go on to develop ME/CFS, making proper diagnosis essential.
This study reminds clinicians that ME/CFS can develop after EBV infection, and proper identification of the triggering infection is crucial for patient care. For ME/CFS researchers, it reinforces the importance of studying post-viral mechanisms, particularly EBV as a potential disease trigger. Understanding the link between acute viral infections and ME/CFS development may eventually lead to earlier intervention strategies.
This single case report cannot establish causal mechanisms linking EBV to ME/CFS development, nor can it quantify risk factors or predict which patients will progress to chronic disease. The 13.5% figure cited is from literature review, not primary data collection in this case. Case reports are anecdotal and do not prove that EBV infection causes ME/CFS in the general population.
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
Howanietz, Helmuth, Graf, Ulrike, & Kainz, Theresa (2022). [Fatigue Doesn't Always have to be caused by SARS-CoV-2: Case Report].. Padiatrie und Padologie. https://doi.org/10.1007/s00608-022-00989-8
BibTeX
@article{mecfsatlas-howanietz-2022-fatigue-doesn,
author = {Howanietz, Helmuth and Graf, Ulrike and Kainz, Theresa},
title = {[Fatigue Doesn't Always have to be caused by SARS-CoV-2: Case Report].},
journal = {Padiatrie und Padologie},
year = {2022},
doi = {10.1007/s00608-022-00989-8},
note = {PubMed: 35611157},
url = {https://www.mecfsatlas.com/evidence/howanietz-2022-fatigue-doesn},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/howanietz-2022-fatigue-doesn
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