Bacteria in blood from fibromyalgia patients include the Aquabacterium genus, producing metabolites with inflammatory properties in vitro. Results from a pilot study

Fibromyalgia syndrome (FMS) is a chronic musculoskeletal pain disorder with unknown cause.1 Chronic diffuse pain, stiffness, multiple tender points, fatigue, poor sleep, and increased pain response to pressure (allodynia) are classic symptoms of FMS.2 FMS affects approximately 2% of the population and is more common in women with a ratio of about 7:1 between women and men. Current research points to both central and peripheral nervous system dysfunctions including altered nociceptor sensitivity, as well as systemic inflammation,3 including increased levels of proinflammatory cytokines such as Tumor Necrosis Factor-α (TNF-α ).4 FMS has symptomatic overlap with another chronic pain disorder, Chronic fatigue syndrome (CFS). It has been postulated that both FMS and CFS could have underlying microbial etiologies.5,6 Furthermore, similarities in symptoms between FMS and CFS and “sickness behavior” implicate an immune component.7-9 Sickness behavior results from the release of proinflammatory cytokines by leukocytes in response to bacterial lipopolysaccharide and other toxins and leads to low-grade systemic inflammation which has been implicated in chronic pain, depression, and fatigue,10,11 the hallmark symptoms of FMS and CFS.