A 58 yo patient with a hx of CLL presents with a chief complaint of dyspnea, wheezing, and cough for 3 days. He is noted to be tachypneic with o2 sats of 91% on RA. There is diffuse expiratory wheezing. Peripheral WBC count is 199,000, increased from a baseline of ~80,000. A CT scan shows scattered interstital infiltrates. What is going on with this patient and what is the indicated therapy?