CD40LG and myositis disease: Breakthrough fever overnight of 102 degrees Fahrenheit; patient had decreased concentration, but was oriented to person, place, and time. West Nile IgM blood positive, however, can be falsely elevated. HIV negative, ANA screen negative, negative rheumatology panel. Continued antibiotics ceftriaxone, acyclovir, doxycycline, vancomycin; MRI brain without contrast showed no evidence of acute intracranial process. MRI STIR protocol, done to examine the patient's foot rash, showed increased T2 signal on both legs; suspicious of myositis.