After ruling out causes of general fatigue and determining that the patient has chronic fatigue, testing for EBV, HHV6
, mycotoxins, and sleep disturbances is a good starting point.
Also tested were DNA viruses HSV, VZV, CMV, EBV, HHV6
A and B, BK, and adenovirus, as well as human genomic DNA.
HHV6 is particularly important in young children with febrile convulsions, and CMV and EBV can occasionally be found in the immunosuppressed patient.
Now, we know that: enteroviruses can be detected in blood as a surrogate for CSF; HSV, EBV and adenovirus can be detected in plasma in immunosuppressed persons with serious disease; the amount of CMV, EBV, HIV, HCV and HIV in blood correlates with treatment outcome; and the best way of diagnosing HHV6 is by PCR of a plasma sample.
Recent studies have shown that a high prevalence of herpes virii such as CMV, HHV6
and EBV in CD patients (Wakefield et al.
DNA was not found in any patients who had encephalitis, febrile seizures, or a seizure disorder.
Viral culture for certain herpesviruses, such as EBV and HHV6, is technically difficult and not done in routine diagnostic laboratories.
Viral strains used for HSV2, VZV, EBV, CMV, and HHV6 were G, Rod, B95-8, AD169, and Z-29, respectively.