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Specialist Clinics

Chronic fatigue

  • Introduction

    This guideline relates to chronic fatigue syndrome (CFS) in paediatric patients. CFS is a condition marked by persistent fatigue lasting over three months, often following a viral illness or health related event. It has no identifiable cause and significantly impacts daily activities like school, sport, and socialising.

    The Royal Children's Hospital provides tertiary level care for CFS. Patients referred to the RCH should be linked with a local/community paediatrician prior to referring.

    When to refer

    • Patients <18 years of age
    • Once a diagnosis of CFS has been made by a local medical officer (LMO) or paediatrician 

    Wait time for appointments 

    Specialist Clinic wait times

    Services available closer to home

    Alternative paediatric services available in Victoria:

    • Monash Medical Centre

    Referral criteria/required information

    • Detailed history and assessment, including duration of symptoms and impact on function for:
      • Fatigue
      • Post-exertional malaise
      • Other symptoms such as pain or autonomic symptoms (CVS/GI/GU/CNS)
      • Co-morbidities (physical or psychological)
    • Growth charts, including current height and weight
    • Observations including lying and standing HR and BP (at base, 1 mins and 5 mins post standing)
    • Blood tests:
      • Anti-nuclear antibody (ANA)
      • Calcium, magnesium, phosphate (CMP)
      • Coeliac serology
      • Creatine Kinase (CK)
      • Electrolytes, urea, creatinine (EUC)
      • Erythrocyte sedimentation rate (ESR)
      • Ferritin
      • Full blood count (FBC)
      • Glucose
      • Liver function test (LFT)
      • TSH
      • Vitamin D
    • Midstream Urine (MSU)
    • Providers involved in current care (including local paediatrician if LMO referring)

    How to refer

    Specialist Clinics referral

    Please complete the above and submit via:

    Facsimile (03) 9345 5034 or
    Email     screferrals@rch.org.au
    Urgent referral or clinical query     call ED admitting officer or Adolescent Medicine on-call (03) 9345 5522

    Information for families

    • Initial appointment will be with a paediatrician and will last 50-60mins
    • Generally assessment will require more than one appointment, with subsequent appointments lasting 25-30mins
    • In person and telehealth appointments are offered, with the expectation that at least one appointment will be attended in person annually
    • During the care episode the young person will spend time alone with the paediatrician

    Resources and links

    Acknowledgements

    The development of this guideline was coordinated by the Department of Adolescent Medicine (Dr Colette Reveley). Guideline reviewed in February 2025.