Fatigue as the Chief Complaint

Given the widespread prevalence of fatigue emerging as a prominent concern among patients and the challenges physicians encounter with its evaluation, this article by German experts offers a comprehensive, evidence-based, and multidimensional diagnostic and therapeutic approach. The goal is to suggest a well-structured care strategy for individuals who continue to remain undiagnoed and unexplained fatigue.
Fatigue has proven to be a complex problem, with no universally accepted pathophysiology. The strategies typically employed to mitigate this condition encompass extended periods of rest and sleep, alongside a reduction or elimination of potential sources of excessive stress. Within the medical landscape, the entity known as chronic fatigue syndrome (CFS) has undergone a recent nomenclatural change to "systemic exertion intolerance disease" (SEID). This syndrome is characterized by a prolonged duration of fatigue, persisting for a minimum of half a year, accompanied by the presence of four to six associated symptoms. These include tiredness, disruptions in sleep patterns, muscular and articular discomfort, craniofacial pain, compromised cognitive function, orthostatic symptoms, and decrease in daily activities. In the course of differential diagnosis, a spectrum of pathologies necessitate meticulous consideration. Mental health diseases, oncology, anemia, endocrine irregularities, infectious agents, hepatic diseases, as well as the influence of environmental factors collectively form a tapestry that clinicians must consider in their pursuit of accurate diagnosis and effective intervention.