Long, Sarah S · The Journal of infection · 2016 · DOI
This medical guideline helps doctors figure out what causes unexplained fevers in children and how to treat them. The article explains that many children who come to doctors with persistent tiredness after a fever may not have a serious infection—instead, they might just be deconditioned (out of shape) and need to gradually return to normal activities like school and exercise.
This guideline is relevant to ME/CFS because it addresses how clinicians differentiate between true infections and post-viral fatigue syndromes in young patients. The recognition that persistent fatigue following acute febrile illness can represent deconditioning rather than ongoing infection is important for understanding how ME/CFS may be misclassified or underdiagnosed in pediatric populations.
This guideline does not establish diagnostic criteria for ME/CFS or prove that deconditioning is the primary cause of post-viral fatigue in all cases. It does not provide evidence about the pathophysiology of fatigue syndromes, nor does it address whether some cases of persistent fatigue involve immunological or metabolic dysfunction rather than simple deconditioning.
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
Long, Sarah S (2016). Diagnosis and management of undifferentiated fever in children.. The Journal of infection. https://doi.org/10.1016/j.jinf.2016.04.025
BibTeX
@article{mecfsatlas-long-2016-diagnosis-management,
author = {Long, Sarah S},
title = {Diagnosis and management of undifferentiated fever in children.},
journal = {The Journal of infection},
year = {2016},
doi = {10.1016/j.jinf.2016.04.025},
note = {PubMed: 27209095},
url = {https://www.mecfsatlas.com/evidence/long-2016-diagnosis-management},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/long-2016-diagnosis-management
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