Symptoms and Signs of Chronic Fatigue Syndrome Anthony L. Komaroff and Dedra Buchwald From the Divisions of General Medicine, Departments of Medicine,

This review summarizes the symptoms and signs seen in patients with chronic fatigue syn-drome (CFS). It is based on the authors ' experience with twocohorts of f\J510 patients with chronic debilitating fatigue and on the reported experience of other investigators with similar patients. The most characteristic symptoms of CFS are the sudden onset of an infectious-type illness, the subsequent chronic and debilitating fatigue, and postexertional malaise; many patients also have recurrent fevers, pharyngitis, adenopathy, myalgias, sleep disorders, and cognitive impairment. In many respects, the symptoms and signs of chronic fa-tigue syndrome (CFS) are nonspecific. As outlined in the work-ing case definition of CFS developed under the leadership of the Centers for Disease Control (CDC), many well-recognized organic illnesses can produce chronic fatigue and the as-sociated symptoms and signs of CFS [1] and, obviously, so can primary psychoneuroses. We believe certain symptoms and signs of CFS may be help-ful in distinguishing it from these various organic and psy