Chronic fatigue syndrome (CFS) is a type of illness characterized by a prolonged feeling of tiredness and exhaustion, even after days of rest. Its cause is unknown, but research has been done to prove it is caused by virus. A 29-year-old female complained of experiencing chronic fatigue for two years. Her symptoms included poor blood circulation, chronic feelings of coldness, sudden loss of muscle flexibility, muscle weakness, muscle ache (especially in the limbs and neck), weight loss, short term memory loss, onset of blurred vision and sore throat. She also experienced sudden chills while exercising, and sometimes exercising made her feel worse. She complained of sleep cycles that were not refreshing due to insomnia or hypersomnia. She also had trouble concentrating, remembering facts and coping with normal daily activity. She often felt depressed and unmotivated. Her symptoms were similar to those listed in previous case studies and research performed concerning chronic fatigue syndrome. She was treated with Osteopathic Manipulative Treatment (OMT), which improved her range of motion, muscle pain and flexibility. Infectious etiology, co-morbid depression, immunology and differential gene expressions are discussed.