Symptoms of prolonged or chronic fatigue

End

Chronic Fatigue Syndrome

Criteria for severity of fatigue are met AND four or more of the following symptoms are concurrently present for >6 months:

Pharyngitis
Tender cervical or axillary lymph nodes
Myalgias
Polyarthralgia
New headaches
Sleep that patient reports as unrefreshing
Postexertion malaise
Memory or concentration impairment

If fatigue persists or relapses for ≥6 months, diagnose either chronic fatigue syndrome or idiopathic chronic fatigue, accordingly

If abnormal, pursue appropriate further diagnostic evaluation

Idiopathic Chronic Fatigue

Criteria for fatigue severity or symptoms of chronic fatigue syndrome are NOT met

ALT, alanine aminotransferase; BUN, blood urea nitrogen; Ca²⁺ , calcium; CBC, complete blood count; ESR, erythrocyte sedimentation rate; PO₄^3- , phosphate; TSH, thyroid-stimulating hormone; UA, urinalysis.

History and physical examination

Mental status examination

If abnormal (findings of infection, neoplasm, or thyroid disease), pursue appropriate diagnostic tests

Laboratory testing (CBC, ESR, serum electrolytes, glucose, BUN, creatinine, alkaline phosphatase, ALT, Ca²⁺ , PO₄^3- , total protein, globulin, albumin, TSH, and UA)

If abnormal, evaluate with psychiatric or neurologic examination