男患,21岁,学生。以发热头痛,咳嗽7天,血痰,每日约100～250ml右侧中下部胸痛,伴右肩背部牵扯痛3天于1991年1月15日以“大叶性肺炎”收入我院。入院查体:T41℃,R48次/分,P130次/分,Bp17/10kPa急性热、重病容,神志恍惚。颈软,唇发绀,浅表淋巴结不大。右中下肺语颤增强,第3肋以下叩浊,叩痛,呼吸音减弱,少量中细湿音,血痰为鲜红色混合均匀的泡沫状血痰。血象:WBC12.5×10~9/L,中性0.82,杆核0.07,淋巴细胞0.11。心电图示窦速。X线正位片报告右中下肺大片实变影,边缘模糊,右心缘不清,右膈顶及肋膈角消失,右上肺及左肺正常。右侧位片示右中下肺实变,上缘相当于斜裂,水平裂,前肋膈角变钝,后肋膈角未显。提示:右中下肺大叶性肺炎,累及同侧胸膜。痰培养2次均为蜂窝哈夫尼亚菌生长。药敏结果:氯霉素高敏,庆大霉素、 Male suffering, 21 years old, student. To fever headache, cough for 7 days, bloody sputum, daily about 100 ~ 250ml right lower chest pain, accompanied by right shoulder back pain for 3 days in January 15, 1991 to “lobar pneumonia” income in our hospital. Admission examination: T41 ℃, R48 times / min, P130 beats / min, Bp17 / 10kPa acute fever, severe disease, trance. Neck soft, cyanotic lips, superficial lymph nodes is not large. The right middle and lower lung fibrillation increased, the first three below the tap turbidity, percussion pain, breath sounds weakened, a small amount of fine wet sound, bloody sputum as bright red mixed foamy bloody sputum. Blood: WBC12.5 × 10 ~ 9 / L, neutral 0.82, rod nuclear 0.07, lymphocytes 0.11. ECG shows sinus speed. X-ray film reported right middle and lower lung large real change, blurred edges, right heart margin is not clear, right diaphragm top and costophrenic angle disappears, right upper quadrant and left lung normal. The right flank shows the right middle and lower lung consolidation, the upper edge is equivalent to oblique split, horizontal split, anterior mediastinal angle becomes dull, posterior costophrenic angle was not significant. Tip: Right middle and lower lobar pneumonia, involving the ipsilateral pleura. Sputum culture were honeycomb Hafu bacteria growth 2 times. Susceptibility results: chloramphenicol hypersensitivity, gentamicin,