Larbcharoensub, Noppadol, Boonsakan, Paisarn, Aroonroch, Rangsima et al. · The Southeast Asian journal of tropical medicine and public health · 2011
This study describes seven cases of a rare fungal infection (histoplasmosis) that affected the adrenal glands—small organs that help manage stress and energy in the body. All patients experienced chronic fatigue as their main symptom, and most recovered after treatment. While this infection is uncommon, it shows that certain fungal infections can cause fatigue-like illness and should be considered when evaluating patients with unexplained chronic tiredness.
This study demonstrates that fungal infection of the adrenal glands can present as chronic fatigue syndrome and may mimic or co-occur with immunological dysfunction. For ME/CFS research, it highlights the importance of considering infectious and endocrine etiologies in differential diagnosis, particularly in immunocompromised or chronically fatigued populations, and suggests that adrenal pathology warrants investigation in persistent fatigue cases.
This case series does not establish that Histoplasma capsulatum is a common cause of ME/CFS or that adrenal histoplasmosis accounts for a significant proportion of ME/CFS cases. The study cannot prove causation between the fungal infection and fatigue symptoms, nor does it compare incidence rates with control populations. The small sample size and geographical origin (Southeast Asia) limit generalizability to other populations.
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 →
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