Aix Marseille University, IRD, MEPHI, IHU, méditerranée infection, AP-HM, 13385 Marseille cedex 05, France.
Aix Marseille University, IRD, MEPHI, IHU, méditerranée infection, AP-HM, 13385 Marseille cedex 05, France.
Med Mal Infect. 2019 Mar;49(2):140-149. doi: 10.1016/j.medmal.2019.01.006. Epub 2019 Feb 2.
Post-infectious chronic fatigue syndrome is a public health problem. Etiologies and physiopathological mechanisms are unknown. Some viruses are known to be involved in post-infectious chronic fatigue syndrome, but the role of bacterial infection is still questioned, especially in cases of post-treatment Lyme disease syndrome where subjective symptoms are regularly attributed to the presence of the dormant bacterium without scientific evidence. However, the medical experience of recalcitrant infections, relapses, and reactivations questions the role of "dormant bacteria" in asymptomatic latent infections as well as in subjective symptoms. We summarized scientific literature data on post-bacterial infection chronic fatigue syndrome, the role of dormant bacteria in latent infections, and bacterial asymptomatic carriage. Subjective symptoms described in post-infectious chronic fatigue syndromes are still misunderstood and there is no evidence suggesting that such symptoms could be related to dormant bacterial infection or carriage of viable bacteria. Psychological trauma may be part of these subjective symptoms. Post-infectious chronic fatigue syndrome could nonetheless be due to unknown microorganisms. Antibiotic treatment is not required for latent infections, except for latent syphilis and latent tuberculosis infections to prevent, after the primary infection, progression to the secondary or tertiary stage of the disease.
感染后慢性疲劳综合征是一个公共卫生问题。其病因和病理生理机制尚不清楚。一些病毒已被证实与感染后慢性疲劳综合征有关，但细菌感染的作用仍存在争议，特别是在治疗后莱姆病综合征中，尽管没有科学证据，但主观症状经常归因于休眠细菌的存在。然而，医学上对顽固感染、复发和再激活的经验质疑了“休眠细菌”在无症状潜伏感染以及主观症状中的作用。我们总结了关于细菌感染后慢性疲劳综合征、休眠细菌在潜伏感染中的作用以及细菌无症状携带的科学文献数据。感染后慢性疲劳综合征中描述的主观症状仍未被充分理解，也没有证据表明这些症状与休眠细菌感染或携带活细菌有关。心理创伤可能是这些主观症状的一部分。感染后慢性疲劳综合征可能是由未知的微生物引起的。除了预防原发性感染后进展为疾病的二期或三期外，潜伏感染不需要进行抗生素治疗，例如潜伏梅毒和潜伏结核病感染。
