Chronic Fatigue Syndrome and Bone Marrow Defects of the Jaw - A Case Report on Additional Dental X-Ray Diagnostics with Ultrasound.
Lechner, Johann, Schick, Fabian · International medical case reports journal · 2021 · DOI
Quick Summary
This case report describes a young man with ME/CFS who had headaches and tinnitus but no visible bone problems on standard X-rays. When doctors used ultrasound imaging, they found a suspicious area in his lower jawbone. Surgery revealed a fungal infection (aspergillosis) and inflamed tissue that standard X-rays had missed. This suggests that ultrasound might be a better tool for detecting hidden bone and jaw problems in some ME/CFS patients.
Why It Matters
Many ME/CFS patients experience unexplained symptoms like headaches and tinnitus that may indicate underlying bone or infection problems. This study suggests that standard dental X-rays might miss serious conditions, and that ultrasound imaging could reveal hidden infections or bone damage. Better diagnostic tools could help identify treatable complications that may contribute to ME/CFS symptoms.
Observed Findings
Standard X-ray imaging (panoramic radiographs and CBCT) failed to detect bone abnormalities
Trans-alveolar ultrasound identified a suspicious area in the lower left mandible
Surgical exploration revealed ischemic, fatty tissue and a black area subsequently identified as aspergillosis
Elevated RANTES/CCL5 expression found in affected tissue indicating chronic inflammatory signaling
Inferred Conclusions
Trans-alveolar ultrasound is superior to conventional radiography for detecting bone marrow defects and fungal colonization in the jaw
Chronic inflammatory signaling and fungal colonization may represent a manifestation of systemic disease in ME/CFS
Complementary imaging techniques beyond radiography are necessary to fully elucidate bone manifestations in systemic diseases like ME/CFS
Remaining Questions
How common are bone marrow defects and fungal infections in ME/CFS populations?
Does aspergillosis or other fungal infections play a causal role in ME/CFS symptomatology, or is this an incidental finding?
What This Study Does Not Prove
This single case report does not prove that aspergillosis or bone marrow defects are common in ME/CFS patients, nor does it establish a causal relationship between fungal infections and ME/CFS. It does not demonstrate that TAU screening should be routine in all ME/CFS patients. The finding may represent an incidental co-occurrence rather than a disease mechanism.
Tags
Symptom:FatigueSensory Sensitivity
Biomarker:Cytokines
Method Flag:PEM Not DefinedWeak Case DefinitionSmall SampleExploratory Only