Purtilo, D T · Canada diseases weekly report = Rapport hebdomadaire des maladies au Canada · 1991
This article discusses the importance of distinguishing patients with ME/CFS (the commonly recognized illness) from those who have dual infections or weakened immune systems that only look like ME/CFS. The authors argue that some patients appearing to have ME/CFS may actually have other treatable conditions involving multiple infections, and recommend long-term studies tracking people who develop ME/CFS-like symptoms after documented viral infections.
This work addresses a critical diagnostic challenge: distinguishing true ME/CFS from conditions that mimic it but have different causes and potentially treatable underlying pathologies. For patients and researchers, this distinction is vital because misdiagnosis could delay appropriate treatment and misdirect research efforts away from identifying ME/CFS's true etiology.
This editorial does not provide empirical data demonstrating how many ME/CFS patients actually have dual infections or immunodeficiency, nor does it present diagnostic criteria to distinguish between these conditions. It calls for such research rather than reporting original findings, so it cannot establish the prevalence or clinical significance of CAEBV-related presentations in ME/CFS 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 →
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
Purtilo, D T (1991). Dual infections of the immune system in patients with chronic active Epstein-Barr virus infection mimicking chronic fatigue syndrome.. Canada diseases weekly report = Rapport hebdomadaire des maladies au Canada. https://pubmed.ncbi.nlm.nih.gov/1669350/
BibTeX
@article{mecfsatlas-purtilo-1991-dual-infections,
author = {Purtilo, D T},
title = {Dual infections of the immune system in patients with chronic active Epstein-Barr virus infection mimicking chronic fatigue syndrome.},
journal = {Canada diseases weekly report = Rapport hebdomadaire des maladies au Canada},
year = {1991},
note = {PubMed: 1669350},
url = {https://www.mecfsatlas.com/evidence/purtilo-1991-dual-infections},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/purtilo-1991-dual-infections
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