患者男,47岁。因受凉后发热(体温38～40℃)伴咳痰,前胸部隐痛,当地医院按“感冒”予青霉素静滴4天,咳嗽减轻,体温正常,X线胸片发现双肺多发团片状阴影。遂于抗炎的同时加抗痨药治疗20余天,症状及肺部阴影未见好转,且咯血1次,量约10ml。否认结核病接触史,有吸烟史30年,每日40支 Male patient, 47 years old. Due to the cold after fever (body temperature 38 ~ 40 ℃) with sputum, pain in the anterior chest, the local hospital according to “cold” to penicillin intravenous infusion for 4 days, reduce cough, normal body temperature, chest X-ray found multiple lobular flaky . Then anti-inflammatory drugs plus anti-tuberculosis treatment for more than 20 days, the symptoms and lung shadow did not improve, and hemoptysis 1, the amount of about 10ml. Denied the history of tuberculosis exposure, smoking history for 30 years, 40 daily