By E. Van Hoof, Clin Psych, PhD, P. De Becker, PhD, K. De Meirleir, MD, PhD. Pediatric chronic fatigue syndrome (CFS) posits even more challenges for professional caregivers in comparison with adult CFS samples. Most children with CFS display a decrease in school attendance and a decrease in social activities. As several conditions such as school phobia, primary psychiatric disorders or family disturbance present the same characteristics, the diagnostic process appears more complex. Family disturbance, moreover, is often specified as child abuse, neglect or even Munchausen-by-proxy. As skepticism is frequently associated with a diagnosis of CFS, patients and parents mus fend for themselves, fighting allegations of child abuse and neglect. This case study illustrates what happens when such allegations are put forward.