1- Know the duration  of methotrexate treatment 
do a differntial TLC looking for esinophilia as an indicator of drug induced ILD
see formal echo to see the Lt vent function for faer of co-existing Lt ht failure and see also the pulmonARY ARTERY PRESSURE 
gIVE LEVOFLOXACIN + lINEZOLID + CEFIPIME 
CONSULT rHUMATOLOGY AND THINK IN CYCLOPHOSPHAMIDE IF NEEDED AND IF PROCALCITONIN IS NEGATIVE
ALSO DO SPUTUM EX FOR FUNGAL HYPHAE