Monday, March 10, 2008

The frequency and the frustration of unexplained chronic fatigue are well described by Jennifer Huget ["Tired Beyond Belief," Health, March 4]. As is often the case, a common and curable condition was omitted from the discussion: Chronic sinusitis causes significant and occasionally severe fatigue in about half of the 14 percent of affected Americans.

Internists are frequently unaware of this association and often overlook this treatable illness. As in unexplained chronic fatigue, there are no objective laboratory tests to confirm the severity or the presence of sinus-related fatigue. Fortunately, specialized surveys offer significant help in measuring fatigue severity and in documenting changes after treatment. In a recent edition of the medical journal Laryngoscope, three co-investigators and I noted substantial reduction in fatigue following sinus surgery in each of 28 studies analyzing this subject and in a pooled analysis of the entire group.

Vigorous treatment of sinusitis is necessary in all patients with sinus symptoms and otherwise unexplained fatigue.

ALEXANDER C. CHESTER

Washington

The writer is a clinical professor of medicine at Georgetown University Medical Center.