Lechner, Johann, Schick, Fabian · International medical case reports journal · 2021 · DOI
This case report describes a young man with ME/CFS who had headaches and tinnitus but no visible bone problems on standard X-rays. When doctors used ultrasound imaging, they found a suspicious area in his lower jawbone. Surgery revealed a fungal infection (aspergillosis) and inflamed tissue that standard X-rays had missed. This suggests that ultrasound might be a better tool for detecting hidden bone and jaw problems in some ME/CFS patients.
Many ME/CFS patients experience unexplained symptoms like headaches and tinnitus that may indicate underlying bone or infection problems. This study suggests that standard dental X-rays might miss serious conditions, and that ultrasound imaging could reveal hidden infections or bone damage. Better diagnostic tools could help identify treatable complications that may contribute to ME/CFS symptoms.
This single case report does not prove that aspergillosis or bone marrow defects are common in ME/CFS patients, nor does it establish a causal relationship between fungal infections and ME/CFS. It does not demonstrate that TAU screening should be routine in all ME/CFS patients. The finding may represent an incidental co-occurrence rather than a disease mechanism.
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
Lechner, Johann & Schick, Fabian (2021). Chronic Fatigue Syndrome and Bone Marrow Defects of the Jaw - A Case Report on Additional Dental X-Ray Diagnostics with Ultrasound.. International medical case reports journal. https://doi.org/10.2147/IMCRJ.S306641
BibTeX
@article{mecfsatlas-lechner-2021-chronic-fatigue,
author = {Lechner, Johann and Schick, Fabian},
title = {Chronic Fatigue Syndrome and Bone Marrow Defects of the Jaw - A Case Report on Additional Dental X-Ray Diagnostics with Ultrasound.},
journal = {International medical case reports journal},
year = {2021},
doi = {10.2147/IMCRJ.S306641},
note = {PubMed: 33907473},
url = {https://www.mecfsatlas.com/evidence/lechner-2021-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/lechner-2021-chronic-fatigue
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