求翻译：Fever should prompt a thorough investigation for an infectious etiology, and if bronchoscopy is employed, a bronchoalveolar lavage cell count and flow cytometry can be useful. The lavage fluid will often show a shift away from a neutrophilic cell type to a predominantly lymphocytic infiltrate, with an increased CD4:CD8 ratio [56, 57]. Additionally, a small study by Inokuma et al. revealed a decline in the serum absolute lymphocyte count below 500cells/mm3 was closely associated with MTX drug toxicity [58]. Imaging with HRCT characteristically displays a diffuse interstitial pattern in greater than 93% of patients with MTX pneumonitis. Pleural thickening and less commonly pleural effusions were also found in a small subset of patients [49]. While it is exceedingly unnecessary, an open lung biopsy can help distinguish between RA-ILD and MTX pneumonitis. In general, MTX pneumonitis will have features of acute and organizing diffuse alveolar damage with cellular interstitial infiltrates with or without granulomas [59]. This pattern may also be seen in some infections but generally differs from the classic pathologic features of UIP and NSIP in RA-ILD. However, given the availability of other medications to treat RA, open lung biopsy is rarely necessary.是什么意思？

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